Provider Demographics
NPI:1578866158
Name:BOSSA, MARGARITA MARIA (LSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:MARIA
Last Name:BOSSA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LAWTON ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807
Mailing Address - Country:US
Mailing Address - Phone:732-221-0710
Mailing Address - Fax:
Practice Address - Street 1:249 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1423
Practice Address - Country:US
Practice Address - Phone:201-798-2167
Practice Address - Fax:201-333-4425
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05654500104100000X
NJ44SC055901001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker