Sondra Iacullo Bogursky, MD
Internal Medicine in Waterbury, CT. Individual provider (NPI-1).
NPI number1790711059
StatusActive
Last updated in NPPESOct 19, 2021
Details
- NPI
- 1790711059
- Entity type
- Individual (NPI-1)
- Name
- Sondra Iacullo Bogursky
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 25, 2006
- Certification date
- Oct 19, 2021
- Last updated
- Oct 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 042480 | CT | Yes |
| 208000000X | Pediatrics | 042480 | CT |
Practice location
95 Scovill St3rd Floor
Waterbury, CT 06706-1113
Phone 203-709-3800 · Fax 203-709-3869
Mailing address
56 Franklin St3rd Floor
Waterbury, CT 06706-1221
Phone 203-709-8873 · Fax 203-709-8689
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