Healthcare Provider Details

I. General information

NPI: 1699892950
Provider Name (Legal Business Name): EDITH J BOSCHEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

12 MOUNTAIN VIEW DR
CHESTER NJ
07930-3104
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5329
  • Fax: 973-290-7393
Mailing address:
  • Phone: 973-971-4144
  • Fax: 973-290-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00127800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: