Christopher Boston
Individual provider Active NPI Contractor · Rosedale, NY
NPI 1972124758 · NPPES record last updated May 3, 2020
Key facts
- NPI
- 1972124758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 24917 148TH Rd
Rosedale, NY 11422-2711 - Phone
- (718) 413-9784
- NPI assigned
- May 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
24917 148TH Rd
Rosedale, NY 11422-2711
Mailing address
PO Box 282
Roosevelt, NY 11575-0282
Phone (718) 216-8924
Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.