Provider Demographics
NPI:1508138736
Name:BOSKER, IRENE SASKIA (RN, MPH)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:SASKIA
Last Name:BOSKER
Suffix:
Gender:F
Credentials:RN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 CLERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4606
Mailing Address - Country:US
Mailing Address - Phone:347-604-1393
Mailing Address - Fax:
Practice Address - Street 1:296 CLERMONT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4606
Practice Address - Country:US
Practice Address - Phone:347-604-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY448246-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse