Bogursky, Sondra Iacullo
Bogursky, Sondra Iacullo is an individual health care provider with primary practice located at 95 Scovill St 3Rd Floor, Waterbury CT 06706-1113. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Bogursky, Sondra Iacullo can be contacted via phone (203) 709-3800.Contact Information
Primary practice address
95 Scovill St 3Rd Floor
Waterbury CT 06706-1113
Phone: (203) 709-3800
Fax: (203) 709-3869
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 042480 | Connecticut |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 042480 | Connecticut |
Profile Details
| NPI number | 1790711059 |
|---|---|
| LBN Legal business name | Bogursky, Sondra Iacullo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Oct 19th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790711059 | NPPES |
| Connecticut | Other | 965608 | USA |
| Connecticut | Other | PENDING | USA |
| Connecticut | Other | 3689809/7698594 | USA |
| Connecticut | Other | 24-70412 | USA |
| Connecticut | MEDICAID | 001424803 | USA |
| Connecticut | Other | 010042480CT01 | USA |
| Connecticut | Other | 246269 | USA |
Popular Providers
-
Krosi, Zife
232 N Elm St , Waterbury CT 06702-1516 -
Fica, Juan
1389 W Main St Tower 2, Suite 320, Waterbury CT 06708-3104 -
Anton, Ionut B
171 Grandview Ave Suite 204, Waterbury CT 06708-2517 -
Mongelluzzo, Philip A.
2247 East Main Street Suite 103, Waterbury CT 06705 -
D'Cunha, Sunil
232 N Elm St , Waterbury CT 06702-1516 -
Windish, Donna M
140 Grandview Ave Suite #101, Waterbury CT 06708-2505 -
Wickersham, Cornelius W
49 Leavenworth St Suite 200, Waterbury CT 06702-2115 -
Sadigh, Majid
140 Grandview Ave Suite #101, Waterbury CT 06708-2505