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Individual

STANLEY D BOSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
495 WATERFRONT DR E, SUITE 230, HOMESTEAD, PA 15120-1140
(412) 325-0397
(412) 461-5490
Mailing address
495 WATERFRONT DR E, SUITE 230, HOMESTEAD, PA 15120-1140
(412) 325-0397
(412) 461-5490

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC001840L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004303232
AETNA PIN
PA
05
0005069140004
PA
01
1015184
GATEWAY HMO PROV NUMBER
PA
01
1156610001
DMERC PROVIDER NUMBER
PA
01
1205011277
DMERC NPI
PA
01
1382437
HIGHMARK GROUP NUMBER
PA
01
1710912845
GROUP NPI
PA
01
63793
HIGHMARK INDIVIDUAL PROV#
PA
Enumeration date
02/03/2006
Last updated
01/15/2014
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