Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 4284 | NY |
NPI | 1871674143 |
---|---|
Provider Name | Morton Bogaty |
First Address | Douglaston, NY 11362-2034 |
Second Address | Douglaston, NY 11362-2034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |