Provider Demographics
NPI:1477602209
Name:BOSS, EUGENE J (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:J
Last Name:BOSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:36 ESSEX RD
Mailing Address - Street 2:LAHEY IPSWICH
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2599
Mailing Address - Country:US
Mailing Address - Phone:978-356-5522
Mailing Address - Fax:978-356-0218
Practice Address - Street 1:36 ESSEX RD
Practice Address - Street 2:LAHEY IPSWICH
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-2599
Practice Address - Country:US
Practice Address - Phone:978-356-5522
Practice Address - Fax:978-356-0218
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2011-01-27
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Provider Licenses
StateLicense IDTaxonomies
MA242617207R00000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110085858AMedicaid
MA110085858AMedicaid