Basic Information
| Provider Information | |||||||||
| NPI: | 1801837851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOGOS | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 CONCORD AVENUE | ||||||||
| Address2: | STE 101 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198023366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027775551 | ||||||||
| FaxNumber: | 3027775567 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 CONCORD AVENUE | ||||||||
| Address2: | STE 101 | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198023366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3027775551 | ||||||||
| FaxNumber: | 3027775567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | MC05538 | NJ | N | Chiropractic Providers | Chiropractor | 111N00000X | DC007803L | PA | N | Chiropractic Providers | Chiropractor | 111N00000X | F1-0000687 | DE | Y | Chiropractic Providers | Chiropractor |
No ID Information.