Provider Demographics
NPI:1437274552
Name:BOGNAR, ANIKO (LCAT)
Entity Type:Individual
Prefix:
First Name:ANIKO
Middle Name:
Last Name:BOGNAR
Suffix:
Gender:F
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 GREENE AVE
Mailing Address - Street 2:1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-7209
Mailing Address - Country:US
Mailing Address - Phone:917-714-9403
Mailing Address - Fax:
Practice Address - Street 1:81 REMSEN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3411
Practice Address - Country:US
Practice Address - Phone:917-714-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000040101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3686177OtherPSYCHOLOGY