Provider Demographics
NPI:1285688804
Name:BOGART, DAVID PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:BOGART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08825-1110
Mailing Address - Country:US
Mailing Address - Phone:908-996-0777
Mailing Address - Fax:908-996-0098
Practice Address - Street 1:207 HARRISON ST
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08825-1110
Practice Address - Country:US
Practice Address - Phone:908-996-0777
Practice Address - Fax:908-996-0098
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00606500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU95935Medicare UPIN
NJ071125Medicare ID - Type Unspecified