Provider Demographics
NPI:1114781614
Name:BOSTON, ZALIYAH B
Entity Type:Individual
Prefix:
First Name:ZALIYAH
Middle Name:B
Last Name:BOSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07063-1364
Mailing Address - Country:US
Mailing Address - Phone:908-821-5647
Mailing Address - Fax:
Practice Address - Street 1:424 CENTRAL AVE STE 2
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-2561
Practice Address - Country:US
Practice Address - Phone:723-204-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician