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General NPI Number Information
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NPI Number | 1023032356
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH BOSKELLO R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 FAR MILL XING
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City | SHELTON
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State | CT
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Zip | 06484-6121
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Country | US
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Telephone | 203-225-8504
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Fax | 203-225-3232
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Provider Business Mailing Address
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Address Line | 41 REVERE LN
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City | FAIRFIELD
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State | CT
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Zip | 06824-7829
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Country | US
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Telephone | 203-254-0028
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Fax | 203-225-3232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5707
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License Number State | CT
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