Provider Demographics
NPI:1750498655
Name:BOVA, JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:BOVA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3339
Mailing Address - Country:US
Mailing Address - Phone:716-675-4134
Mailing Address - Fax:716-675-5733
Practice Address - Street 1:1953 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3339
Practice Address - Country:US
Practice Address - Phone:716-675-4134
Practice Address - Fax:716-675-5733
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX047881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY8890027OtherINDEPENDENT HEALTH
NY00020629005OtherBC/BS
NY5898019OtherGHI
NY161354798OtherAETNA
NYC04788-8OtherWCB
NY00020629005OtherBC/BS
NY5898019OtherGHI