Provider Demographics
NPI:1245056100
Name:BOSCARINO, JOSHUA (MHC-LP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BOSCARINO
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BELL SLIP APT 6J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-6062
Mailing Address - Country:US
Mailing Address - Phone:860-878-7587
Mailing Address - Fax:
Practice Address - Street 1:285 LEXINGTON AVE STE 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3570
Practice Address - Country:US
Practice Address - Phone:917-426-2612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP126308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health