Individual
KARI BOVENZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
638 WESTERN AVE, ALBANY, NY 12203-1830
(518) 489-6822
Mailing address
638 WESTERN AVE, ALBANY, NY 12203-1830
(518) 489-6822
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
191281
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01697947
—
NY
Enumeration date
09/26/2006
Last updated
02/17/2012
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