MEDICARE: SHANIA BOSKIE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1821795576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANIA BOSKIE

Provider Business Mailing Address
First Line	:	74 HOUSTON RD
Second Line	:
City	:	LANSDOWNE
State	:	PA
Zip	:	19050-1726
Country	:	US
Telephone Number	:	267-353-6559
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 HOUSTON RD
Second Line	:
City	:	LANSDOWNE
State	:	PA
Zip	:	19050-1726
Country	:	US
Telephone Number	:	267-353-6559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	02/13/2023

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Directions to “ SHANIA BOSKIE ” Practice Location

Language	Start Address	Practice Location

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