Provider Demographics
NPI:1245339001
Name:BOGOLYUBOV, ALEKSEY V (MD)
Entity type:Individual
Prefix:
First Name:ALEKSEY
Middle Name:V
Last Name:BOGOLYUBOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALEXEI
Other - Middle Name:V
Other - Last Name:BOGOLIOUBOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2209 GENESEE ST
Mailing Address - Street 2:BUSINESS OFFICE ROOM 315
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502
Mailing Address - Country:US
Mailing Address - Phone:315-801-8534
Mailing Address - Fax:315-801-8391
Practice Address - Street 1:35 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-2320
Practice Address - Country:US
Practice Address - Phone:315-735-2294
Practice Address - Fax:315-624-8412
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017228207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease