Provider Demographics
NPI:1841263548
Name:BOGINSKY, IRENE (DO)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:BOGINSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NW 20TH ST STE G2
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7964
Mailing Address - Country:US
Mailing Address - Phone:561-757-6198
Mailing Address - Fax:561-448-6336
Practice Address - Street 1:141 NW 20TH ST STE G2
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7964
Practice Address - Country:US
Practice Address - Phone:561-757-6198
Practice Address - Fax:561-448-6336
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-12
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8052207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02058937Medicaid
NYH14490Medicare UPIN
NY17V072Medicare ID - Type Unspecified