Provider Demographics
NPI:1578900577
Name:BOSCO, JANICE M
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:M
Last Name:BOSCO
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 1:114 NORTH DR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-5108
Mailing Address - Country:US
Mailing Address - Phone:718-727-4134
Mailing Address - Fax:
Practice Address - Street 1:114 NORTH DR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-5108
Practice Address - Country:US
Practice Address - Phone:718-727-4134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist