Active NPI
Mark Bogulavsky, M.A.
- Occupational Therapist
- Rego Park, NY
National Provider Identifier
1932427739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 014283-1
- Practice address
- 6601 Burns St
Apt 6a
Rego Park, NY 11374-3948 - Phone
- (212) 734-7719
- NPI assigned
- May 4, 2010
- Last updated
- May 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 014283-1 | NY | Primary |
Addresses
Primary practice location
6601 Burns St
Apt 6a
Rego Park, NY 11374-3948
Mailing address
6601 Burns St
Apt 6a
Rego Park, NY 11374-3948
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014283 | NY | MD | School Psychologist |
| 014283-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272931200000",
"number": "1932427739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6601 BURNS ST",
"address_2": "APT 6A",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743948"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 BURNS ST",
"address_2": "APT 6A",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743948",
"telephone_number": "212-734-7719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGULAVSKY",
"first_name": "MARK",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-04",
"last_updated": "2010-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "014283-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.