Provider Demographics
NPI:1003210162
Name:JANEBOGURSKYPLLC
Entity Type:Organization
Organization Name:JANEBOGURSKYPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGURSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LICSW
Authorized Official - Phone:603-494-3039
Mailing Address - Street 1:31 BUCKINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4233
Mailing Address - Country:US
Mailing Address - Phone:603-494-3039
Mailing Address - Fax:
Practice Address - Street 1:128 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6720
Practice Address - Country:US
Practice Address - Phone:603-494-3039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health