Individual
DR. JOHN BOSCHETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
580 REED ROAD, BROOMALL, PA 19008
(610) 353-6767
(610) 325-0888
Mailing address
580 REED ROAD, BROOMALL, PA 19008
(610) 353-6767
(610) 325-0888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05004442L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032117001
KEYSTONE
PA
05
—
1071929
—
PA
01
—
477697
HIGHMARK BLUE SHIELD
PA
01
—
5795035
AETNA
PA
Enumeration date
11/03/2006
Last updated
07/27/2010
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