Individual
SUSAN RODRIGUEZ-BOSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
27 S COOKS BRIDGE RD, STE 2-1, JACKSON, NJ 08527-2524
(732) 987-5780
(732) 987-5787
Mailing address
108 S MAIN ST, STE 6, OCEAN GROVE, NJ 07756-2017
(732) 987-5780
(732) 987-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06662300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7963807
—
NJ
Enumeration date
08/09/2006
Last updated
08/10/2018
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