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Individual

DR. DAVID F BOGACKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
3 COOPER PLZ, SUITE 307, CAMDEN, NJ 08103-1438
(856) 342-2328
(856) 541-6137
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00177700
NJ
2084P0802X
Addiction Psychiatry Physician
SI00177700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001664070
AMERIHEALTH PPO
01
010003754
AMERICHOICE
01
0101145000
AMERIHEALTH HMO, KEYSTONE, IBC
01
1127825
HORIZON NJ HEALTH
05
1339303
NJ
01
24702
UNIVERSITY HEALTHPLAN
01
293304000
MAGELLAN
01
4528678
AETNA
01
620004717
RR MEDICARE
Enumeration date
10/11/2006
Last updated
11/20/2019
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