Provider Demographics
NPI:1568790053
Name:BOGDAN PAIN MANAGEMENT SERVICES P.C.
Entity Type:Organization
Organization Name:BOGDAN PAIN MANAGEMENT SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-266-7700
Mailing Address - Street 1:8686 BAY PKWY
Mailing Address - Street 2:SUITE M4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5103
Mailing Address - Country:US
Mailing Address - Phone:718-266-7700
Mailing Address - Fax:718-265-7701
Practice Address - Street 1:8686 BAY PKWY
Practice Address - Street 2:SUITE M4
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5103
Practice Address - Country:US
Practice Address - Phone:718-266-7700
Practice Address - Fax:718-265-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical