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General NPI Number Information
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NPI Number | 1699708503
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOSEPH BOSTON O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 48 N BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1754
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Country | US
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Telephone | 856-678-4800
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Fax | 610-695-9047
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Provider Business Mailing Address
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Address Line | 48 N BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1754
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Country | US
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Telephone | 856-678-4800
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Fax | 610-695-9047
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG-000461
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License Number State | PA
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