MEDICARE: JEFFREY BOMZE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD023534E	PA

General Provider Information

NPI Number	:	1518947225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY BOMZE MD

Provider Business Mailing Address
First Line	:	1991 SPROUL RD
Second Line	:	SUITE 300
City	:	BROOMALL
State	:	PA
Zip	:	19008-3512
Country	:	US
Telephone Number	:	610-325-1390
Fax Number	:	610-325-1373

Provider Business Practice Location Address
First Line	:	1991 SPROUL RD
Second Line	:	SUITE 300
City	:	BROOMALL
State	:	PA
Zip	:	19008-3512
Country	:	US
Telephone Number	:	610-325-1390
Fax Number	:	610-325-1373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	09/17/2014

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Directions to “ JEFFREY BOMZE MD” Practice Location

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