Provider Demographics
NPI:1417908419
Name:BOJEDLA, RAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMA
Middle Name:
Last Name:BOJEDLA
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 1:120 LOCKPORT ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14174-1006
Mailing Address - Country:US
Mailing Address - Phone:716-745-7724
Mailing Address - Fax:
Practice Address - Street 1:120 LOCKPORT ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:NY
Practice Address - Zip Code:14174-1006
Practice Address - Country:US
Practice Address - Phone:716-745-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010018701OtherUNIVERA
NY00973111Medicaid
NY00503465003OtherBLUE CROSS
NY0401777OtherIHA
NY0401777OtherIHA
034653Medicare PIN