Provider Demographics
NPI:1942399795
Name:VALERIE J. BOSSARD, M.D. P.C.
Entity Type:Organization
Organization Name:VALERIE J. BOSSARD, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRES
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-332-8870
Mailing Address - Street 1:8001 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3038
Mailing Address - Country:US
Mailing Address - Phone:215-332-8870
Mailing Address - Fax:215-332-0810
Practice Address - Street 1:8001 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3038
Practice Address - Country:US
Practice Address - Phone:215-332-8870
Practice Address - Fax:215-332-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA059694Medicare ID - Type Unspecified
PAB41304Medicare UPIN