Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 014418 | NY |
Y | 103T00000X | Psychologist | 014418 | NY |
NPI | 1013060789 |
---|---|
Provider Name | Dr. Anthony Paul Bossis |
First Address | Kew Gardens, NY 11415-1148 |
Second Address | New York, NY 10016-6306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |