Provider Demographics
NPI:1235344151
Name:BOCZKO, MIKLOS LAJOS (MD)
Entity Type:Individual
Prefix:
First Name:MIKLOS
Middle Name:LAJOS
Last Name:BOCZKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WOODCREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2325
Mailing Address - Country:US
Mailing Address - Phone:914-683-8929
Mailing Address - Fax:914-683-8929
Practice Address - Street 1:43 WOODCREST AVENUE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2325
Practice Address - Country:US
Practice Address - Phone:914-683-8929
Practice Address - Fax:914-683-8929
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0865452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D46711Medicare UPIN