Provider Demographics
NPI:1235294000
Name:FELDMAN-BOHOSKEY, WENDY (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:FELDMAN-BOHOSKEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:FELDMAN-BOHOSKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 24066
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-0066
Mailing Address - Country:US
Mailing Address - Phone:505-310-5810
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE MEDICO STE 5
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4705
Practice Address - Country:US
Practice Address - Phone:505-310-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00KL87OtherBCBS OF NM
NMNM00KL87OtherBCBS OF NM