Individual
DR. JACKIE M. BOSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-8075
Mailing address
200 W 92ND ST, APT. 5A, NEW YORK, NY 10025-7432
(212) 787-4909
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
P56991
NY
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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