Provider Demographics
NPI:1255630331
Name:BOSEFSKI, LILIANA (RPH)
Entity type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:
Last Name:BOSEFSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-3005
Mailing Address - Country:US
Mailing Address - Phone:201-452-4779
Mailing Address - Fax:
Practice Address - Street 1:1502 UNION VALLEY RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1354
Practice Address - Country:US
Practice Address - Phone:973-728-3172
Practice Address - Fax:973-728-3257
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02519300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist