Basic Information
| Provider Information | |||||||||
| NPI: | 1235254368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOSSI | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 790 NORTHERN BLVD | ||||||||
| Address2: | SUITE K | ||||||||
| City: | SOUTH ABINGTON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184118799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705864141 | ||||||||
| FaxNumber: | 5705866722 | ||||||||
| Practice Location | |||||||||
| Address1: | 790 NORTHERN BLVD | ||||||||
| Address2: | SUITE K | ||||||||
| City: | SOUTH ABINGTON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184118799 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705864141 | ||||||||
| FaxNumber: | 5705866722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 09/23/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA052352 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | 363AM0700X | OA002909 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.