Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 020858-1 | NY |
NPI | 1114449196 |
---|---|
Provider Name | Jennifer Bognar |
First Address | West Seneca, NY 14224-3444 |
Second Address | West Seneca, NY 14224-3444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2017 |
Last Update Date | 03/12/2021 |