Provider Demographics
NPI:1821795576
Name:BOSKIE, SHANIA
Entity Type:Individual
Prefix:
First Name:SHANIA
Middle Name:
Last Name:BOSKIE
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 1:74 HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1726
Mailing Address - Country:US
Mailing Address - Phone:267-353-6559
Mailing Address - Fax:
Practice Address - Street 1:74 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1726
Practice Address - Country:US
Practice Address - Phone:267-353-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist