Provider Demographics
NPI:1720311186
Name:BOSSERT, DARIA (RN)
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:BOSSERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DARIA
Other - Middle Name:
Other - Last Name:DELANEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:109 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1409
Mailing Address - Country:US
Mailing Address - Phone:631-589-3667
Mailing Address - Fax:
Practice Address - Street 1:109 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1409
Practice Address - Country:US
Practice Address - Phone:631-589-3667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY393453-1163W00000X, 163WH0200X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health