Provider Demographics
NPI:1093852568
Name:WOGALTER, DAVID FRANKLIN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FRANKLIN
Last Name:WOGALTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 NORTH RD STE 304
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1173
Mailing Address - Country:US
Mailing Address - Phone:845-451-7233
Mailing Address - Fax:
Practice Address - Street 1:243 NORTH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1172
Practice Address - Country:US
Practice Address - Phone:845-445-4405
Practice Address - Fax:845-454-4056
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87247Medicare UPIN
NYA400160529Medicare PIN