Basic Information
| Provider Information | |||||||||
| NPI: | 1710090212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOSHNAKOV | ||||||||
| FirstName: | SEVDALINA | ||||||||
| MiddleName: | VANGELOVA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 WASHINGTON STREET | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041677 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4300 LONDONDERRY ROAD | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171095317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176577332 | ||||||||
| FaxNumber: | 7179204394 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 01/25/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD066533L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0000X | MD066533L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine | 208M00000X | MD066533L | PA | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.