Provider Demographics
NPI:1689371585
Name:BOJANA JANKOVIC WEATHERLY MD OF NEW JERSEY PC
Entity Type:Organization
Organization Name:BOJANA JANKOVIC WEATHERLY MD OF NEW JERSEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOJANA
Authorized Official - Middle Name:JANKOVIC
Authorized Official - Last Name:WEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-614-3697
Mailing Address - Street 1:9100 WILSHIRE BLVD STE 1000W
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3463
Mailing Address - Country:US
Mailing Address - Phone:646-627-8000
Mailing Address - Fax:646-368-8019
Practice Address - Street 1:1135 MINE HILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-2050
Practice Address - Country:US
Practice Address - Phone:646-627-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty