Provider Demographics
NPI:1225196728
Name:BOGDALSKA, DANUTA MONIKA (PT)
Entity type:Individual
Prefix:
First Name:DANUTA
Middle Name:MONIKA
Last Name:BOGDALSKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 STEEL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3913
Mailing Address - Country:US
Mailing Address - Phone:315-258-8652
Mailing Address - Fax:
Practice Address - Street 1:3 SAINT ANTHONY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4525
Practice Address - Country:US
Practice Address - Phone:315-253-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist