Individual
ALEXANDRA M BOSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 BIRCHWOOD DR, PORT JEFFERSON STATION, NY 11776-3517
(631) 645-4276
Mailing address
7 BIRCHWOOD DR, PORT JEFFERSON STATION, NY 11776-3517
(631) 645-4276
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
335465-01
NY
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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