Provider Demographics
NPI:1467464297
Name:BOGLIA, JOSEPH PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PETER
Last Name:BOGLIA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 BELLE TERRE ROAD
Mailing Address - Street 2:STE 110
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1928
Mailing Address - Country:US
Mailing Address - Phone:631-476-1010
Mailing Address - Fax:631-642-9805
Practice Address - Street 1:200 BELLE TERRE ROAD
Practice Address - Street 2:STE 110
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1928
Practice Address - Country:US
Practice Address - Phone:631-476-1010
Practice Address - Fax:631-642-0105
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2013-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY219312207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPRV0004554OtherMONTEFIORE
NY7X2132OtherEMPIRE BCBS
NY7293637OtherAETNA
NY2120125OtherVYTRA
NYP00161349OtherRAILROAD MEDICARE
NY7293637OtherAETNA
NYPRV0004554OtherMONTEFIORE