MEDICARE: MR. GODFRID BOSSE

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	163WH0200X	Home Health Registered Nurse	808569	NY

General Provider Information

NPI Number	:	1851246094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GODFRID BOSSE

Provider Business Mailing Address
First Line	:	1058 CLYDE RD
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-1211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1058 CLYDE RD
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-1211
Country	:	US
Telephone Number	:	516-884-9205
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ MR. GODFRID BOSSE ” Practice Location

Language	Start Address	Practice Location

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