Provider Demographics
NPI:1659767028
Name:BOGDAN, LAUREN GALINAT (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:GALINAT
Last Name:BOGDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:JEANETTE
Other - Last Name:GALINAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2300 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 2A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-1379
Mailing Address - Country:US
Mailing Address - Phone:302-658-0404
Mailing Address - Fax:302-658-8601
Practice Address - Street 1:2300 PENNSYLVANIA AVE
Practice Address - Street 2:STE 2A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-1379
Practice Address - Country:US
Practice Address - Phone:302-658-0404
Practice Address - Fax:302-658-8601
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-12
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0013622207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty