Dr. Jack Boghossian
Infectious Disease
631 Broadway
Bayonne
, New Jersey 07002-3846
Dr. Jack Boghossian
Infectious Disease
631 Broadway
Bayonne
, New Jersey 07002-3846
(239) 597-0709
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About
Features
Specialties
- Infectious Disease
Languages spoken
- English
Location
First Address
- Dr. Jack Boghossian
- Po Box 93
- Bayonne, NJ
- Zip : 07002-0093
- Fax : (239) 597-0709
- Phone : (239) 597-0704
Second Address
- Dr. Jack Boghossian
- 631 Broadway
- Bayonne, NJ
- Zip : 07002-3846
- Fax : (973) 364-1430
- Phone : (973) 364-2682
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0200X | Infectious Disease | MA81581 | NJ |
National Provider Identifier
| NPI | 1083666010 |
|---|---|
| Provider Name | Dr. Jack Boghossian |
| First Address | Bayonne, NJ 07002-0093 |
| Second Address | Bayonne, NJ 07002-3846 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/05/2006 |
| Last Update Date | 26/03/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4555104 | (05) | NJ |
| E97537 | (02) | NJ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.