Individual
JUNA BOBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
134 NORTH CHATSWORTH AVE, LARCHMONT, NY 10538-1651
(212) 794-2500
(212) 879-3846
Mailing address
4 BRIAR CLOSE RD, LARCHMONT, NY 10538-1009
(216) 255-5700
(866) 618-2917
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
210146
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01906243
—
NY
05
—
102375743 0001
—
PA
05
—
1477044
—
LA
05
—
2932054
—
OH
01
—
913809755
TRICARE NORTH
—
01
—
932T01
BCBS
NY
01
—
932T81
BCBS
NY
01
—
P00971897
RXR MCR
NY
Enumeration date
07/07/2006
Last updated
05/24/2019
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