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General NPI Number Information
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NPI Number | 1962315358
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Entity Type | Individual
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Provider Name | CHAD JEREMY BOGDEWIC
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Gender | Male
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 2644 BANKSVILLE RD
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City | PITTSBURGH
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State | PA
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Zip | 15216-2812
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Country | US
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Telephone | 866-583-6003
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Fax |
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Provider Business Mailing Address
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Address Line | 421 FLORENCE AVE APT 2
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City | PITTSBURGH
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State | PA
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Zip | 15202-2314
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Country | US
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Telephone | 412-292-3328
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH008787
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License Number State | PA
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