Provider Demographics
NPI:1801363015
Name:BOSWELL, MOLLY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:
Practice Address - Street 1:521 MT PLEASANT DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1993
Practice Address - Country:US
Practice Address - Phone:570-342-8500
Practice Address - Fax:570-342-0924
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant