MEDICARE: MRS. PATRICIA A BOSEN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F333461	NY

General Provider Information

NPI Number	:	1467515866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA A BOSEN FNP

Provider Business Mailing Address
First Line	:	815 N BROADWAY
Second Line	:
City	:	SARATOGA SPGS
State	:	NY
Zip	:	12866-1632
Country	:	US
Telephone Number	:	518-580-5550
Fax Number	:	518-580-5556

Provider Business Practice Location Address
First Line	:	815 N BROADWAY
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-1632
Country	:	US
Telephone Number	:	518-580-5550
Fax Number	:	518-580-5556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	08/02/2007

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