Provider Demographics
NPI:1679814255
Name:USZYNSKI, BOGUSLAWA (NP)
Entity Type:Individual
Prefix:
First Name:BOGUSLAWA
Middle Name:
Last Name:USZYNSKI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5342 72 PLACE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378
Mailing Address - Country:US
Mailing Address - Phone:718-424-0134
Mailing Address - Fax:
Practice Address - Street 1:5342 72ND PL
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1518
Practice Address - Country:US
Practice Address - Phone:718-424-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306382363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10071995Medicaid
NY10071995Medicaid
NY10071995Medicare UPIN
NY1007199507Medicare NSC
NY10071995Medicare PIN