Provider Demographics
NPI:1033422167
Name:WEATHERLY, BOJANA JANKOVIC (MD, MSC)
Entity Type:Individual
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First Name:BOJANA
Middle Name:JANKOVIC
Last Name:WEATHERLY
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Gender:F
Credentials:MD, MSC
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Mailing Address - Street 1:9100 WILSHIRE BLVD STE 1000W
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3463
Mailing Address - Country:US
Mailing Address - Phone:646-627-8000
Mailing Address - Fax:646-368-8019
Practice Address - Street 1:245 5TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:646-627-8000
Practice Address - Fax:646-368-8019
Is Sole Proprietor?:No
Enumeration Date:2010-07-18
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA11658207R00000X
NY288259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine