Individual
DR. ELISE LINGBO BOVENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
130 E 77TH ST, NEW YORK, NY 10075-1851
(212) 434-4000
Mailing address
420 W 25TH ST APT 8A, NEW YORK, NY 10001-6553
(978) 905-5581
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
318424
NY
208M00000X
Hospitalist Physician
Primary
318424
NY
Other
Enumeration date
03/30/2019
Last updated
08/31/2024
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