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General NPI Number Information
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NPI Number | 1356321145
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Entity Type | Individual
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Provider Name | PAUL GEORGE BOGOSIAN DC
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7715 WHITAKER AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2854
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Country | US
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Telephone | 215-342-2225
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Fax | 215-342-3232
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Provider Business Mailing Address
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Address Line | 7801 ANITA DR
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2807
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Country | US
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Telephone | 215-342-2225
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Fax | 215-342-3232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC002358L
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License Number State | PA
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