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Individual
MS. MELISSA ANLIE BOHAC
Active
Individual
MS. MELISSA ANLIE BOHAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004188-1
NY
363A00000X
Physician Assistant
Primary
MA001408L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01282104
—
NY
01
—
970014969
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039880
MEDICARE GROUP
PA
Enumeration date
03/16/2006
Last updated
03/01/2021
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