Provider Demographics
NPI:1831235704
Name:BOSCO, VINCENT JAMES (PA)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:JAMES
Last Name:BOSCO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:900 ROUTE 376
Mailing Address - Street 2:STE H
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6496
Mailing Address - Country:US
Mailing Address - Phone:845-592-4915
Mailing Address - Fax:
Practice Address - Street 1:45 FOSTER RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6123
Practice Address - Country:US
Practice Address - Phone:845-226-4590
Practice Address - Fax:855-200-2625
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2019-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY003057363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant