Individual
SHELBY BOSSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 E SHORE RD STE 203, GREAT NECK, NY 11023-2432
(516) 514-5522
Mailing address
310 E SHORE RD STE 203, GREAT NECK, NY 11023-2432
(516) 514-5522
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
308772
NY
363LA2200X
Adult Health Nurse Practitioner
308772
NY
363LG0600X
Gerontology Nurse Practitioner
308772
NY
Other
Enumeration date
10/24/2018
Last updated
02/10/2020
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