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NPI Code Detail

MEDICARE: DR. ROMAN BOIWKA O.D.

MEDICARE: DR. ROMAN BOIWKA O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3982 / T366OH

General Provider Information

NPI Number : 1013005917
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMAN BOIWKA O.D.
Provider Business Mailing Address
First Line : 235 SLEEPY HOLLOW DR
Second Line :
City : AMHERST
State : OH
Zip : 44001-3430
Country : US
Telephone Number : 440-988-9235
Fax Number :
Provider Business Practice Location Address
First Line : 35901 CHESTER RD
Second Line :
City : AVON
State : OH
Zip : 44011-1069
Country : US
Telephone Number : 440-937-4765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ROMAN BOIWKA O.D.” Practice Location

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