Provider Demographics
NPI:1760821292
Name:BOSCH, RAQUEL (DPT)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:BOSCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2805
Mailing Address - Country:US
Mailing Address - Phone:718-269-7330
Mailing Address - Fax:917-208-9330
Practice Address - Street 1:49 MORGAN STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2805
Practice Address - Country:US
Practice Address - Phone:718-269-7330
Practice Address - Fax:914-395-3693
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033310-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist