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NPI Code Detail

MEDICARE: DR. ANGELA BOVA DDS

MEDICARE: DR. ANGELA BOVA DDS
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
1122300000XDentist055017NY

General Provider Information

NPI Number : 1891923389
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA BOVA DDS
Provider Business Mailing Address
First Line : 62 TRAILHEAD LN
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-5048
Country : US
Telephone Number : 646-226-3533
Fax Number :
Provider Business Practice Location Address
First Line : 876 DUTCHESS TPKE
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12603-1540
Country : US
Telephone Number : 845-454-7023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2009
Last Update Date : 10/27/2015

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