Susan Bogosian, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

378615 Issued in NY

Practice address

55 Elm St
Glens Falls, NY 12801-3549

Phone

(518) 793-7273

Fax

(518) 798-5004

NPI assigned

May 27, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Liverpool, NY
  • NPI 1366498768
  NPD (past)
• Conifer Park, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Glens Falls, NY
  • NPI 1972558179
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1215316922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417153",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022417153",
            "telephone_number": "518-952-8140",
            "fax_number": "518-952-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ELM ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013549",
            "telephone_number": "518-793-7273",
            "fax_number": "518-798-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGOSIAN",
        "first_name": "SUSAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "378615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03008326",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Blesso, PHARMD
• Alexander Robert Blumberg, DPT
• Amy E Bly, FNP
• Devon E Bock, MD
• Susan Boggia, AU.D.
• Rebekah Booth
• Joseph Spencer Bordelon, M.D.
• William M Borgos, MD
• Donna Jean Boss, PA
• Julia Bottoni, MD

• Addiction (Substance Use Disorder) Registered Nurse in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Addiction (Substance Use Disorder) Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.