Provider Demographics
NPI:1477782563
Name:ROBERT J. BOS,M.D PC
Entity type:Organization
Organization Name:ROBERT J. BOS,M.D PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAN
Authorized Official - Last Name:BOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-539-7838
Mailing Address - Street 1:985 FIFTH AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:175-397-8389
Mailing Address - Fax:212-758-4244
Practice Address - Street 1:985 FIFTH AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075
Practice Address - Country:US
Practice Address - Phone:917-539-7838
Practice Address - Fax:212-249-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193605207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01562014Medicaid
NYW32832Medicare UPIN