Provider Demographics
NPI:1972850139
Name:BOSWELL, ELSA JANICE
Entity Type:Individual
Prefix:MRS
First Name:ELSA
Middle Name:JANICE
Last Name:BOSWELL
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 1:940 E 215TH ST
Mailing Address - Street 2:3R
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-1153
Mailing Address - Country:US
Mailing Address - Phone:917-569-3395
Mailing Address - Fax:
Practice Address - Street 1:65 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4916
Practice Address - Country:US
Practice Address - Phone:718-935-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist