Healthcare Provider Details

I. General information

NPI: 1922503473
Provider Name (Legal Business Name): BOEV MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 PARRISH STREET SUITE #220
CANANDAIGUA NY
14424
US

IV. Provider business mailing address

1445 PORTLAND AVENUE SUITE #309
ROCHESTER NY
14621
US

V. Phone/Fax

Practice location:
  • Phone: 585-342-2638
  • Fax: 585-730-7500
Mailing address:
  • Phone: 585-342-2638
  • Fax: 585-730-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGEL N. BOEV
Title or Position: OWNER/ NEUROSURGEON
Credential: M.D.
Phone: 585-342-2638