Organization
STANLEY D. BOSTA DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE L LYNCH (OPERATIONS MANAGER)
(412) 461-1108
Entity
Organization
Contact information
Practice address
495 WATERFRONT DR E, SUITE230, HOMESTEAD, PA 15120-1140
(412) 461-1108
(412) 461-5490
Mailing address
495 WATERFRONT DR E, SUITE230, HOMESTEAD, PA 15120-1140
(412) 461-1108
(412) 461-5490
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005069140003
—
PA
01
—
063793XXY
MEDICARE GROUP PROV#
PA
01
—
1083686034
INDIVIDUAL NPI
PA
01
—
1382437
HIGHMARK BS ID NUMBER
PA
01
—
480023599
RAILROAD MEDICARE
PA
Enumeration date
07/11/2006
Last updated
01/08/2014
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