Individual
MRS. JOLENE ELIZABETH BOHENSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
361 N MAIN ST, GLASSBORO, NJ 08028-1920
(856) 881-8618
Mailing address
361 N MAIN ST, GLASSBORO, NJ 08028-1920
(856) 881-8618
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056066
PA
363AM0700X
Medical Physician Assistant
25MP00296500
NJ
Other
Enumeration date
12/02/2012
Last updated
09/09/2016
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