Healthcare Provider Details

I. General information

NPI: 1679631337
Provider Name (Legal Business Name): THOMAS BOJKO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - NEW BRUNSWICK
NEW BRUNSWICK NJ
08901-1928
US

IV. Provider business mailing address

66 WEST GILBERT ST
RED BANK NJ
07701
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-7900
  • Fax:
Mailing address:
  • Phone: 732-212-0051
  • Fax: 732-212-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMA56326
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: