Provider Demographics
NPI:1598796831
Name:DEBRA L BOSHINSKI, OD, PC
Entity Type:Organization
Organization Name:DEBRA L BOSHINSKI, OD, PC
Other - Org Name:BOSHINSKI EYE CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BOSHINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-697-7288
Mailing Address - Street 1:5275 E TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3502
Mailing Address - Country:US
Mailing Address - Phone:717-697-7288
Mailing Address - Fax:717-697-6010
Practice Address - Street 1:5295 E TRINDLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3565
Practice Address - Country:US
Practice Address - Phone:717-697-7288
Practice Address - Fax:717-697-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000863152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA074353OtherMEDICARE GROUP
PA074353Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
PA6356930001Medicare NSC