Individual
AMANDA MARY BOSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2054 TILLOTSON AVE, BRONX, NY 10475-1560
(718) 671-2100
Mailing address
1525 TOWNSEND AVE APT 2E, BRONX, NY 10452-6023
(646) 301-7858
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305415
NY
Other
Enumeration date
10/22/2012
Last updated
08/09/2017
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