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General NPI Number Information
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NPI Number | 1396874525
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Entity Type | Individual
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Provider Name | ALLA BOOHOFF D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 650 CENTRAL AVE SUITE A
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City | CEDARHURST
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State | NY
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Zip | 11516-2301
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Country | US
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Telephone | 516-295-1924
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Fax | 516-295-9345
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Provider Business Mailing Address
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Address Line | 76 CONKLIN AVE
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City | WOODMERE
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State | NY
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Zip | 11598-1342
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Country | US
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Telephone | 516-295-1924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 223039
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License Number State | NY
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