Individual
JAMES D BOVIENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2800 MAIN ST, ST. VINCENT'S MEDICAL CENTER, BRIDGEPORT, CT 06606-4201
(203) 576-5177
Mailing address
100 W 58TH ST, APT 6F, NEW YORK, NY 10019-2129
(203) 576-5177
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
02816
KY
207P00000X
Emergency Medicine Physician
Primary
160395
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000569669
ANTHEM BCBS
KY
05
—
7100050090
—
KY
Enumeration date
06/01/2006
Last updated
06/20/2014
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