Provider Demographics
NPI:1629577705
Name:BOVA, SARAH E
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:BOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5913 BEACON HILL LN
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-3307
Mailing Address - Country:US
Mailing Address - Phone:814-464-4500
Mailing Address - Fax:
Practice Address - Street 1:9885 ROCKSIDE RD STE 157
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-6272
Practice Address - Country:US
Practice Address - Phone:216-957-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program