Provider Demographics
NPI:1689885204
Name:KROP, BOHDAN G (OTRL)
Entity Type:Individual
Prefix:
First Name:BOHDAN
Middle Name:G
Last Name:KROP
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13309-1397
Mailing Address - Country:US
Mailing Address - Phone:315-942-4301
Mailing Address - Fax:315-942-5994
Practice Address - Street 1:232 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:NY
Practice Address - Zip Code:13309-1397
Practice Address - Country:US
Practice Address - Phone:315-942-4301
Practice Address - Fax:315-942-5994
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004431-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist