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Individual
GREGORY PAUL BOVENZI
Active
Individual
GREGORY PAUL BOVENZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
732940
NY
164W00000X
Licensed Practical Nurse
302177
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
403684
NY
Other
Enumeration date
01/16/2021
Last updated
11/01/2021
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