Provider Demographics
NPI:1043869662
Name:BOVE, EMILY MARY
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MARY
Last Name:BOVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GUNN RD
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-4166
Mailing Address - Country:US
Mailing Address - Phone:973-702-0305
Mailing Address - Fax:
Practice Address - Street 1:279 TIMBERWOLF DR
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-7772
Practice Address - Country:US
Practice Address - Phone:570-588-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PART0078742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program