Shane Bolger

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

5406 Sanctuary Blvd
Riverdale, NJ 07457-1656

Phone

(215) 880-1834

NPI assigned

Nov 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1851869937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 SANCTUARY BLVD",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571656",
            "telephone_number": "215-880-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 SANCTUARY BLVD",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571656",
            "telephone_number": "215-880-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bria Gabrielle Bernstein, RN
• Bharat Dasani, MD
• BJ'S Wholesale Club Inc.
• Donald C. Bogert Jr., DMD
• Katie Bogusz, M.D.
• Daniel G Bowden
• Lori A. Brolsma, DC
• Ralph D Brown, LPC
• Benjamin Meir Burton, P.T.
• Lynn Freeman Carten, APRN

• Electroneurodiagnostic Specialist/Technologist in Riverdale, NJ
• Providers in Riverdale, NJ by specialty
• Electroneurodiagnostic Specialist/Technologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.