Individual
JARED CARL BOVALINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2375 GREENTREE RD, CARNEGIE, PA 15106-4203
(412) 276-1560
(412) 276-5805
Mailing address
701 TECHNOLOGY DR STE 150, CANONSBURG, PA 15317-9531
(412) 531-2902
(412) 531-2948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS016857
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030072870002
—
PA
01
—
416271JFZ
MEDICARE PROVIDER NUMBER
PA
Enumeration date
05/16/2012
Last updated
07/06/2023
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