Provider Demographics
NPI:1124313192
Name:JEJNA, BOHDAN MARKIAN (MA CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:BOHDAN
Middle Name:MARKIAN
Last Name:JEJNA
Suffix:
Gender:M
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-2303
Mailing Address - Country:US
Mailing Address - Phone:585-324-2010
Mailing Address - Fax:
Practice Address - Street 1:353 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-2303
Practice Address - Country:US
Practice Address - Phone:585-324-2010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011942-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist