MEDICARE: MS. DENNIS BOLGER CRNA

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	367500000X	Certified Registered Nurse Anesthetist	4744401	NY

General Provider Information

NPI Number	:	1417006743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENNIS BOLGER CRNA

Provider Business Mailing Address
First Line	:	95 GRASSLANDS RD RM 2395
Second Line	:
City	:	VALHALLA
State	:	NY
Zip	:	10595-1652
Country	:	US
Telephone Number	:	914-347-0380
Fax Number	:	914-347-0390

Provider Business Practice Location Address
First Line	:	41 E POST RD
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601-4607
Country	:	US
Telephone Number	:	914-681-0600
Fax Number	:

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	05/06/2026

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