Provider Demographics
NPI:1912081472
Name:BOCZARSKI, CONSTANCE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:MARIE
Last Name:BOCZARSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 N FEDERAL HWY
Mailing Address - Street 2:150A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1657
Mailing Address - Country:US
Mailing Address - Phone:561-330-9004
Mailing Address - Fax:561-330-9006
Practice Address - Street 1:7601 N FEDERAL HWY
Practice Address - Street 2:150A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1657
Practice Address - Country:US
Practice Address - Phone:561-330-9004
Practice Address - Fax:561-330-9006
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7983111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70298Medicare ID - Type Unspecified
FLU89441Medicare UPIN