Individual
DR. EZRA RALPH BOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
994 W SHERMAN AVE BLDG 2, VINELAND, NJ 08360-6937
(631) 534-7246
(856) 457-5681
Mailing address
76 PARK ROW, LAWRENCE, NY 11559-2524
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA10009300
NJ
2085R0204X
Vascular & Interventional Radiology Physician
MD2019-0581
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2013
Last updated
01/18/2024
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