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NPI Code Detail

MEDICARE: JASON MICHAEL BOSKO

MEDICARE: JASON MICHAEL BOSKO
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
1247200000XOther Technician
2101Y00000XCounselor37AC00831000NJ

General Provider Information

NPI Number : 1558415562
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON MICHAEL BOSKO
Provider Business Mailing Address
First Line : 1 CORAL SEA ST
Second Line :
City : KAPOLEI
State : HI
Zip : 96707-3693
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1127 ROUTE 47 S STE 9
Second Line :
City : RIO GRANDE
State : NJ
Zip : 08242-1609
Country : US
Telephone Number : 609-486-2003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 04/28/2025

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Directions to “ JASON MICHAEL BOSKO ” Practice Location

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