Diana Bosinski

Individual provider Active NPI Physical Therapy Assistant · Deer Park, NY

NPI 1447869409 · NPPES record last updated Jul 27, 2020

Key facts

NPI
1447869409
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
011552-1 (NY)
Practice address
84 W 13TH St
Deer Park, NY 11729-4018
Phone
(917) 592-8955
NPI assigned
Jul 27, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
011552-1NYMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 011552-1 NY Yes

Addresses

Primary practice location

84 W 13TH St
Deer Park, NY 11729-4018

Mailing address

84 W 13TH St
Deer Park, NY 11729-4018

Other providers in Deer Park, NY

All providers in Deer Park, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.