Individual
DR. MATHIAS P.G. BOSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4872
(212) 606-1674
(212) 472-3713
Mailing address
PO BOX 29234, NEW YORK, NY 10087-4872
(212) 606-1674
(212) 472-3713
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
183199
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01706812
—
NY
Enumeration date
08/25/2006
Last updated
01/05/2024
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