1528179868 NPI number — MR. RICHARD K BOSKO DC

Table of content: MR. RICHARD K BOSKO DC (NPI 1528179868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528179868 NPI number — MR. RICHARD K BOSKO DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOSKO
Provider First Name:
RICHARD
Provider Middle Name:
K
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528179868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 SALT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALTSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15681-1127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-639-3117
Provider Business Mailing Address Fax Number:
724-639-3117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 SALT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALTSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15681-1127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-639-3117
Provider Business Practice Location Address Fax Number:
724-639-3117
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC005031L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1500233 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1524672 . This is a "UMW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 13549 . This is a "HA HA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47873 . This is a "ASHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: BO486005 . This is a "BC & BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 812996 . This is a "US HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00134742 . This is a "RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 216981 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 78829 . This is a "MED PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: BO486005 . This is a "OHP" identifier . This identifiers is of the category "OTHER".




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