Provider Demographics
NPI:1497808380
Name:BOJE, GRETCHEN LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:LOUISE
Last Name:BOJE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 GROTON RD
Mailing Address - Street 2:
Mailing Address - City:FREEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13068-9413
Mailing Address - Country:US
Mailing Address - Phone:607-844-8566
Mailing Address - Fax:607-844-8953
Practice Address - Street 1:194 GROTON RD
Practice Address - Street 2:
Practice Address - City:FREEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13068-9413
Practice Address - Country:US
Practice Address - Phone:607-844-8566
Practice Address - Fax:607-844-8953
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10036-4WOtherWORKMANS COMPENSATION ID
NYC10036-4WOtherWORKMANS COMPENSATION ID
NYBA0224Medicare PIN