Provider Demographics
NPI:1770245979
Name:BOJOVIC, KATERINA (OTR)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:BOJOVIC
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 39TH PL APT 4F
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-4346
Mailing Address - Country:US
Mailing Address - Phone:347-220-3318
Mailing Address - Fax:
Practice Address - Street 1:4307 39TH PL APT 4F
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-4346
Practice Address - Country:US
Practice Address - Phone:347-220-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025260-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist