MEDICARE: DEBRA BOGEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD065922L	PA

General Provider Information

NPI Number	:	1134191299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA BOGEN

Provider Business Mailing Address
First Line	:	3414 5TH AVE
Second Line	:	CHOB BUILDING, 1ST FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3205
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3414 5TH AVE
Second Line	:	CHOB BUILDING, 1ST FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3205
Country	:	US
Telephone Number	:	412-692-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	03/25/2021

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Directions to “ DEBRA BOGEN ” Practice Location

Language	Start Address	Practice Location

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