1417000498 NPI number — MS. ELIZABETH PATSY BOBDE M.D.

Table of content: MS. ELIZABETH PATSY BOBDE M.D. (NPI 1417000498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417000498 NPI number — MS. ELIZABETH PATSY BOBDE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOBDE
Provider First Name:
ELIZABETH
Provider Middle Name:
PATSY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMAS
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
PATSY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417000498
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 N BROADWAY
Provider Second Line Business Mailing Address:
SUITE #201
Provider Business Mailing Address City Name:
YONKERS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10701-1309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-966-1900
Provider Business Mailing Address Fax Number:
914-966-0028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 N BROADWAY
Provider Second Line Business Practice Location Address:
SUITE #201
Provider Business Practice Location Address City Name:
YONKERS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10701-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-966-1900
Provider Business Practice Location Address Fax Number:
914-966-0028
Provider Enumeration Date:
01/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  217852 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)