Individual
GARY ROBERT BOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 E ADAMS ST STE 2104, SYRACUSE, NY 13210-2306
(315) 464-6543
Mailing address
750 E ADAMS ST STE 2104, SYRACUSE, NY 13210-2306
(315) 464-6543
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
024064-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024064-01
LICENSE
NY
Enumeration date
10/28/2019
Last updated
10/28/2019
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