Lorieta H Bogdan, M.D.
Individual provider Active NPI Pediatrics Physician · Spring Lake, NJ
NPI 1992962088 · NPPES record last updated May 17, 2008
Key facts
- NPI
- 1992962088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 25MA06559900 (NJ)
- Practice address
- 2220 1St Ave
Spring Lake, NJ 07762-1649 - Phone
- (732) 449-5653
- NPI assigned
- May 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA06559900 | NJ | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA06559900 | NJ | Yes |
Addresses
Primary practice location
2220 1St Ave
Spring Lake, NJ 07762-1649
Mailing address
2220 1St Ave
Spring Lake, NJ 07762-1649
Phone (732) 449-5653
Other providers in Spring Lake, NJ
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- Lisa M Baldini
- Gabrielle Ann Bereski
- Maya Brady
- Brian Brateris
- Linda Brooks
- Built to Move
- Tara Callaghan
All providers in Spring Lake, NJ · Pediatrics Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.