Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | MA49878 | NJ |
NPI | 1477563286 |
---|---|
Provider Name | Dr. Jeffrey R Boscamp |
First Address | Hackensack, NJ 07601-1914 |
Second Address | Hackensack, NJ 07601-1914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |