Provider Demographics
NPI:1831444025
Name:PATEL-BOFINGER, ANISHA D (OD)
Entity type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:D
Last Name:PATEL-BOFINGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2815
Mailing Address - Country:US
Mailing Address - Phone:215-639-4500
Mailing Address - Fax:
Practice Address - Street 1:3046 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2815
Practice Address - Country:US
Practice Address - Phone:215-639-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist