Individual
CASEY BOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10819 ROCKAWAY BLVD, SOUTH OZONE PARK, NY 11420-1034
(718) 845-2620
Mailing address
1156 E 82ND ST, BROOKLYN, NY 11236-4702
(347) 881-8192
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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