Provider Demographics
NPI:1912159641
Name:BOVA, JOSEPH J
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:BOVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1537
Mailing Address - Country:US
Mailing Address - Phone:914-693-7845
Mailing Address - Fax:
Practice Address - Street 1:21 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1537
Practice Address - Country:US
Practice Address - Phone:914-693-7845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist