Individual
DR. JAY BOSNIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
143 PAVILION AVE, LONG BRANCH, NJ 07740-6415
(732) 229-7440
(732) 229-2149
Mailing address
143 PAVILION AVE, LONG BRANCH, NJ 07740-6415
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA02566100
NJ
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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