Healthcare Provider Details

I. General information

NPI: 1093277378
Provider Name (Legal Business Name): CARRIE E BOSS AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 GROVE RD
PITTSBURGH PA
15236-1691
US

IV. Provider business mailing address

121 CHERRINGTON DR
PITTSBURGH PA
15237-3916
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-4377
  • Fax: 412-885-9181
Mailing address:
  • Phone: 412-526-6554
  • Fax: 412-885-9181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT006375
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: