Provider Demographics
NPI:1467941575
Name:BOHNAK, CARISA ELAINE (MD)
Entity type:Individual
Prefix:
First Name:CARISA
Middle Name:ELAINE
Last Name:BOHNAK
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 1:10 DUTTON DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1899
Mailing Address - Country:US
Mailing Address - Phone:330-746-7691
Mailing Address - Fax:330-743-8368
Practice Address - Street 1:4060 N RIVER RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1039
Practice Address - Country:US
Practice Address - Phone:330-746-7691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35153605207W00000X
TN65496207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology