Individual
MS. MARY ELLEN BOVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
519 W 114TH ST, MAIL CODE 3601, NEW YORK, NY 10027-7036
(212) 854-5818
(212) 854-3372
Mailing address
84 GREELEY AVE, STATEN ISLAND, NY 10306-2412
(212) 854-5818
(212) 854-3372
Taxonomy
Speciality
Code
Description
License number
State
163WC1400X
College Health Registered Nurse
Primary
340629-1
NY
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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