Provider Demographics
NPI:1275300881
Name:BOGLE, CASSANDRA (RN)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:BOGLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1106
Mailing Address - Country:US
Mailing Address - Phone:845-680-4000
Mailing Address - Fax:
Practice Address - Street 1:2 1ST AVE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1106
Practice Address - Country:US
Practice Address - Phone:845-680-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY454855163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator