1881540235 NPI number — TONE AND GLOW MD MEDICAL AESTHETICS AND WEIGHT LOSS

Table of content: MS. BROOKE BOSONAC (NPI 1255210944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881540235 NPI number — TONE AND GLOW MD MEDICAL AESTHETICS AND WEIGHT LOSS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TONE AND GLOW MD MEDICAL AESTHETICS AND WEIGHT LOSS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1881540235
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 MARY WIL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27455-2262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-339-1227
Provider Business Mailing Address Fax Number:
336-360-0246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1931 NEW GARDEN RD STE 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27410-2558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-579-8400
Provider Business Practice Location Address Fax Number:
336-360-0246
Provider Enumeration Date:
03/09/2026

Additional Information

Authorized Official

Authorized Official Last Name:
SCHOOLER
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
336-579-8400

Provider Taxonomy Codes

  • Taxonomy code: 207RB0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com