Provider Demographics
NPI:1184883456
Name:BOGDANOWICH, ALLISON (MS)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BOGDANOWICH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 PARK AVE
Mailing Address - Street 2:3RD FL HUNTINGTON DRUG & ALCOHOL PROJECT
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-271-3591
Mailing Address - Fax:631-271-5497
Practice Address - Street 1:423 PARK AVE
Practice Address - Street 2:3RD FL HUNTINGTON DRUG & ALCOHOL PROJECT
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-271-3591
Practice Address - Fax:631-271-5497
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP59529101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health