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General NPI Number Information
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NPI Number | 1306829023
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Entity Type | Individual
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Provider Name | SUSAN A BOSS PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2380 MCGINLEY RD
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City | MONROEVILLE
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State | PA
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Zip | 15146-4400
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Country | US
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Telephone | 412-856-2440
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Fax | 412-856-4334
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Provider Business Mailing Address
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Address Line | 2380 MCGINLEY RD
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City | MONROEVILLE
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State | PA
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Zip | 15146-4400
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Country | US
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Telephone | 412-856-2440
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Fax | 412-856-4334
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA001776L
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License Number State | PA
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