Provider Demographics
NPI:1689817611
Name:BOGOVIC, DENNIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:BOGOVIC
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GATES AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5911
Mailing Address - Country:US
Mailing Address - Phone:516-942-8150
Mailing Address - Fax:516-827-4023
Practice Address - Street 1:31 GATES AVE
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-5911
Practice Address - Country:US
Practice Address - Phone:516-942-8150
Practice Address - Fax:516-827-4023
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist