Jay Bosniak, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA02566100 Issued in NJ

Practice address

143 Pavilion Ave
Long Branch, NJ 07740-6415

Phone

(732) 229-7440

Fax

(732) 229-2149

NPI assigned

Jun 4, 2014

Last updated

Jun 4, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jay B Bosniak MD PA

  • Legal Medicine
  • Long Branch, NJ
  • NPI 1629117239
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1346653607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 PAVILION AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 PAVILION AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406415",
            "telephone_number": "732-229-7440",
            "fax_number": "732-229-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSNIAK",
        "first_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA02566100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Carl Bloodgood, PT
• Blue Angel Home Care LLC
• Renee Bolognese, APN
• Carl P Bontempo, MD
• Heather Borbely, CRNA
• Merna Botros
• Jana Bova, LCSW
• William Patrick Boyan Jr., M.D.
• Carolyn Boyle, FNP-C
• Gregory Braslavsky, MD, PC

• Specialist in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.