Provider Demographics
NPI:1275569808
Name:BOLLENGIER, WILLIAM E (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:BOLLENGIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 COLUMBIA ST
Mailing Address - Street 2:STE 302
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3923
Mailing Address - Country:US
Mailing Address - Phone:845-454-9955
Mailing Address - Fax:845-454-9949
Practice Address - Street 1:1 COLUMBIA ST
Practice Address - Street 2:STE 302
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3923
Practice Address - Country:US
Practice Address - Phone:845-454-9955
Practice Address - Fax:845-454-9949
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY199439208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00664979OtherRAILROAD MEDICARE
NY01643512Medicaid
A41127Medicare UPIN
NY314812Medicare ID - Type Unspecified