Sondra Iacullo Bogursky MD

NPI 1790711059 - Pediatrics - 208000000X

NPI Details
NPI 1790711059
Gender Female
Enumeration Date 06/25/2006
Last Updated 07/14/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
95 SCOVILL ST
3RD FLOOR
WATERBURY CT, 06706-1113, US
Phone (203) 709-3800
Fax (203) 709-3869
Business Location
56 FRANKLIN ST
3RD FLOOR
WATERBURY CT, 06706-1221, US
Phone (203) 709-8873
Fax (203) 709-8689
Toxanomy
Taxonomy Code 208000000X
License State Connecticut
License Number 042480
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According to our database, Sondra Iacullo Bogursky MD NPI is 1790711059, taxonomy code is 208000000X and license number is 042480, license state is located at Connecticut. Sondra Iacullo Bogursky MD physically located at 95 Scovill St, Waterbury CT, 06706-1113. NPI Number Sondra Iacullo Bogursky MD has the Individual type.

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1790711059 NPI number is provided on an as is basis without warranty of any kind. 1790711059 is maintained by the National Plan & Provider Enumeration System. The contents of Sondra Iacullo Bogursky MD are for informational purposes only.