Provider Demographics
NPI:1740544055
Name:BOHANNA, PATRICIA (MSED)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BOHANNA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2213 E TREMONT AVE
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6301
Mailing Address - Country:US
Mailing Address - Phone:718-683-3775
Mailing Address - Fax:
Practice Address - Street 1:2213 E TREMONT AVE
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6301
Practice Address - Country:US
Practice Address - Phone:718-683-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist