Provider Demographics
NPI:1306960695
Name:BOGGIANO, KATRINA RITA (CSW)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:RITA
Last Name:BOGGIANO
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:624 E 20TH ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1421
Mailing Address - Country:US
Mailing Address - Phone:917-446-8672
Mailing Address - Fax:212-533-2711
Practice Address - Street 1:31 W 9TH ST
Practice Address - Street 2:1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9206
Practice Address - Country:US
Practice Address - Phone:212-946-5270
Practice Address - Fax:212-533-2711
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-053847-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical