Provider Demographics
NPI:1922503473
Name:BOEV MEDICAL, PLLC
Entity Type:Organization
Organization Name:BOEV MEDICAL, PLLC
Other - Org Name:BOEV CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ NEUROSURGEON
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BOEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-342-2638
Mailing Address - Street 1:1445 PORTLAND AVENUE
Mailing Address - Street 2:SUITE #309
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621
Mailing Address - Country:US
Mailing Address - Phone:585-342-2638
Mailing Address - Fax:585-730-7500
Practice Address - Street 1:183 PARRISH STREET
Practice Address - Street 2:SUITE #220
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424
Practice Address - Country:US
Practice Address - Phone:585-342-2638
Practice Address - Fax:585-730-7500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOEV MEDICAL, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-27
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty