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General NPI Number Information
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NPI Number | 1821063132
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Entity Type | Individual
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Provider Name | BOGUMILA E. JEDRAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 831 BOSTON POST ROAD SUITE 203 MILFORD ANESTHESIA ASSOCIATES P.C.
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City | MILFORD
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State | CT
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Zip | 06460
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Country | US
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Telephone | 203-783-1831
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 3160 MILFORD ANESTHESIA ASSOCIATES, P.C.
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City | MILFORD
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State | CT
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Zip | 06460-9768
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Country | US
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Telephone | 203-783-1831
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 040233
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License Number State | CT
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