Individual
JEFFREY A BOGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 EAST GENESEE ST. SUITE 101, SYRACUSE, NY 13210
(315) 476-3535
(315) 476-4140
Mailing address
1000 EAST GENESEE ST. SUITE 101, SYRACUSE, NY 13210
(315) 476-3535
(315) 476-4140
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
190748
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01412362
—
NY
01
—
190748
NYS LICENSE
NY
Enumeration date
07/10/2006
Last updated
09/12/2012
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