Individual
MR. MICHAEL A BOSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.O.
Contact information
Practice address
33 VILLAGE GREEN DR, LITCHFIELD, CT 06759
(860) 567-4565
Mailing address
33 VILLAGE GREEN DR, LITCHFIELD, CT 06759-3419
(860) 567-4565
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
737
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100000737CT01
ANTHEM BLUE CROSS BLUE SH
CT
Enumeration date
12/01/2006
Last updated
07/08/2007
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