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General NPI Number Information
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NPI Number | 1104979376
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Entity Type | Organization
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Legal Business Name | CONRADO BOJA, M.D. LLC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1182 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4824
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Country | US
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Telephone | 201-833-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1182 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4824
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Country | US
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Telephone | 201-833-9000
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | ROEY HINE
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Credential |
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Telephone | 973-751-7515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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