Susan Jane Bostaph, RN

Individual provider Active NPI School Registered Nurse · Tonawanda, NY

NPI 1861769929 · NPPES record last updated Nov 17, 2011

Key facts

NPI
1861769929
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
263993 (NY)
Practice address
44 Westfall Dr
Tonawanda, NY 14150-7130
Phone
(716) 874-8719
Fax
(716) 874-8550
NPI assigned
Nov 17, 2011
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
263993NYMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 263993 NY Yes

Addresses

Primary practice location

44 Westfall Dr
Tonawanda, NY 14150-7130

Mailing address

44 Westfall Dr
Tonawanda, NY 14150-7130
Phone (716) 874-8719

Other providers in Tonawanda, NY

All providers in Tonawanda, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.