Individual
JEANINE LEE BOSSART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 RATZER RD STE B7, WAYNE, NJ 07470-7704
(973) 317-0155
(973) 317-0149
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00480400
NJ
Other
Enumeration date
01/18/2019
Last updated
08/11/2022
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