Provider Demographics
NPI:1881643849
Name:BOSWORTH, BRIAN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PAUL
Last Name:BOSWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:575 LEXINGTON AVE
Mailing Address - Street 2:SUITE 540 GWILKENS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6102
Mailing Address - Country:US
Mailing Address - Phone:212-590-5152
Mailing Address - Fax:212-590-5798
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:ROOM J314
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-4479
Practice Address - Fax:212-746-5212
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY217817207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology