Provider Demographics
NPI:1235984782
Name:BODROVA, ELIZAVETA (MD)
Entity Type:Individual
Prefix:
First Name:ELIZAVETA
Middle Name:
Last Name:BODROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 OCEAN STREET NORTH, BONDI
Mailing Address - Street 2:
Mailing Address - City:SYDNEY
Mailing Address - State:NSW
Mailing Address - Zip Code:02026
Mailing Address - Country:AU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 LANSDOWNE AVENUE
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023
Practice Address - Country:US
Practice Address - Phone:610-237-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program