Iravani, Boshra Sophia

Iravani, Boshra Sophia is an individual health care provider with primary practice located at 1400 Pelham Pkwy S , Bronx NY 10461-1138. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Dentist Anesthesiologist. Dental Providers / Dentist Anesthesiologist is her primary health care specialty. Iravani, Boshra Sophia can be contacted via phone (212) 844-6578.

Contact Information

Primary practice address
1400 Pelham Pkwy S Bronx NY 10461-1138
Phone: (212) 844-6578
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Dentist Anesthesiologist 1223D0004X GA1968 California

Profile Details

NPI number 1487033619
LBN Legal business name Iravani, Boshra Sophia
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2015
Last updated Sep 3rd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487033619 NPPES
New York MEDICAID MK97647D

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