Provider Demographics
NPI:1104064872
Name:BOLA, PARVINDER (MD)
Entity type:Individual
Prefix:
First Name:PARVINDER
Middle Name:
Last Name:BOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 88TH ST
Mailing Address - Street 2:APT # 2F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5643
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:274 88TH ST
Practice Address - Street 2:APT # 2F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5643
Practice Address - Country:US
Practice Address - Phone:916-212-4524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program