Healthcare Provider Details

I. General information

NPI: 1861722142
Provider Name (Legal Business Name): LINDA BOJMAN MS,RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 01/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8120 OLD YORK RD
ELKINS PARK PA
19027-1595
US

IV. Provider business mailing address

PO BOX 45731
PHILADELPHIA PA
19149-5731
US

V. Phone/Fax

Practice location:
  • Phone: 215-888-0016
  • Fax:
Mailing address:
  • Phone: 215-888-0016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN002438
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: