Individual
DONNA JEAN BOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
102 PARK ST, CR WOOD CANCER CENTER, GLENS FALLS, NY 12801-4403
(518) 926-6620
(518) 926-1954
Mailing address
PO BOX 304, GLENS FALLS, NY 12801
(518) 926-6620
(518) 926-1954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002440
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01280304
—
NY
01
—
P00007864
RR MEDICARE
NY
Enumeration date
11/07/2005
Last updated
06/05/2012
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