| Specialty | Taxonomy Code | |
|---|---|---|
| * | Primary Care | 261QP2300X |
| Clinic/Center | 261Q00000X | |
| Health Service | 261QH0100X | |
| Student Health | 261QS1000X | |
| Urgent Care | 261QU0200X |
* Indicates primary specialty
| NPI Number | 1013974864 |
| Legal business name LBN |
BOMRAY MEDICAL CLINIC |
| Authorized official | JERRI OLSZEWSKI - (BILLING REPRESENTATIVE) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 04/26/2006 |
| Last updated | 07/20/2010 - About 16 years ago |
| Sole proprietor1 | Not specified |
| Identifiers |
|
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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