Provider Demographics
NPI:1518530518
Name:BOSA ACUPUNCTURE WELLNESS PLLC
Entity Type:Organization
Organization Name:BOSA ACUPUNCTURE WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:716-578-4734
Mailing Address - Street 1:346 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14204-2056
Mailing Address - Country:US
Mailing Address - Phone:716-578-4734
Mailing Address - Fax:
Practice Address - Street 1:346 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-2056
Practice Address - Country:US
Practice Address - Phone:716-578-4734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty