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Individual

TYISHA BOSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
400 CLAREMONT AVE, JERSEY CITY, NJ 07304-4357
(347) 957-4673
Mailing address
89 BARTLETT ST, BROOKLYN, NY 11206-4463
(718) 828-2666

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
777853
NY

Other

Enumeration date
12/19/2022
Last updated
12/19/2022
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