Individual
DR. SIDNEY T BOGARDUS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Mailing address
40 TEMPLE ST, SUITE 4A, NEW HAVEN, CT 06510-2715
(203) 777-0304
(203) 401-4687
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
034398
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001343988
—
CT
Enumeration date
05/16/2006
Last updated
02/14/2012
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