Bogannam, Nicholas S

Bogannam, Nicholas S is an individual health care provider with primary practice located at 1995 Post Rd , Fairfield CT 06824-5723. He recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Nutrition. Chiropractic Providers / Chiropractor is his primary health care specialty. Bogannam, Nicholas S can be contacted via phone (203) 259-4731.

Contact Information

Primary practice address
1995 Post Rd Fairfield CT 06824-5723
Phone: (203) 259-4731
Fax: (203) 259-7319
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 253CT01 Connecticut
Chiropractic Providers / Nutrition 111NN1001X 253CT01 Connecticut

Profile Details

NPI number 1841359916
LBN Legal business name Bogannam, Nicholas S
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Sep 8th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841359916 NPPES
Connecticut Other 253CT01 STATE LICENSE NUMBER
Connecticut Other 06-1066319 STATE LICENSE NUMBER

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