Susan Lynn Bognar, SPEECH PATHOLOGIST

Individual provider Active NPI Speech-Language Pathologist · Grand Island, NY

NPI 1760639595 · NPPES record last updated Aug 22, 2008

Key facts

NPI
1760639595
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
013509 (NY)
Practice address
2101 Fix Rd
Grand Island, NY 14072-2547
Phone
(716) 570-8960
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
013509NYMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013509 NY Yes

Addresses

Primary practice location

2101 Fix Rd
Grand Island, NY 14072-2547

Mailing address

2101 Fix Rd
Grand Island, NY 14072-2547
Phone (716) 570-8960

Other providers in Grand Island, NY

All providers in Grand Island, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.