Individual
BETH ANN BOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NYCPS
Contact information
Practice address
31 INDUSTRIAL BLVD, MEDFORD, NY 11763-2220
(631) 924-4411
(631) 924-0563
Mailing address
31 INDUSTRIAL BLVD, MEDFORD, NY 11763-2220
(631) 924-4411
(631) 924-0563
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
175T00000X
—
175T00000X
Peer Specialist
NONE
—
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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