Provider Demographics
NPI:1508912155
Name:MARK P. VOGEL, PH.D AND ASSOCIATES
Entity Type:Organization
Organization Name:MARK P. VOGEL, PH.D AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:VOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:607-336-9914
Mailing Address - Street 1:60 MIDLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1947
Mailing Address - Country:US
Mailing Address - Phone:607-336-9914
Mailing Address - Fax:607-334-4881
Practice Address - Street 1:60 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1947
Practice Address - Country:US
Practice Address - Phone:607-336-9914
Practice Address - Fax:607-334-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006122103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY51872BMedicare PIN