Individual
ANITA M BODROGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
96 COURT ST, PLATTSBURGH, NY 12901-2733
(518) 562-2369
(518) 562-2263
Mailing address
96 COURT ST, PLATTSBURGH, NY 12901-2733
(518) 562-2369
(518) 562-2263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
230057
NY
208D00000X
General Practice Physician
000000230057
NY
208D00000X
General Practice Physician
0320000511
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN3526
—
VT
01
—
4128833
MVP
VT
01
—
68536
BC BS
VT
01
—
800084544
BC BS
NY
Enumeration date
10/24/2006
Last updated
04/10/2024
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