Provider Demographics
NPI:1144200882
Name:NEGREA, BOGDAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:BOGDAN
Middle Name:D
Last Name:NEGREA
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 1:63 ARGYLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1701
Mailing Address - Country:US
Mailing Address - Phone:718-806-1609
Mailing Address - Fax:
Practice Address - Street 1:7005 35TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3970
Practice Address - Country:US
Practice Address - Phone:718-806-1609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2067032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01876255Medicaid
NY04257OtherGHI MEDICARE
NY595371Medicare PIN
NY04257OtherGHI MEDICARE