Individual
KANCHANA BOSEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2141 N BEVERLY AVE STE 101, TUCSON, AZ 85712-2155
(520) 324-6290
(520) 324-6291
Mailing address
PO BOX 31235, TUCSON, AZ 85751-1235
(520) 324-2308
(520) 324-1406
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
200927
NY
2080P0006X
Developmental - Behavioral Pediatrics Physician
200927
NY
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
56115
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02235656
—
NY
05
—
336861
—
AZ
01
—
Z214068
MEDICARE
AZ
Enumeration date
04/06/2006
Last updated
09/26/2023
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