Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 044702-1 | NY |
Y | 213EG0000X | General Practice | 044702-1 | NY |
NPI | 1003812447 |
---|---|
Provider Name | Dr. Victoire Bogui |
First Address | Bronx, NY 10457-5524 |
Second Address | Bronx, NY 10457-5524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D25561 | (02) | NY |