Boghossian, Jack
Boghossian, Jack is an sole proprietor health care provider with primary practice located at 631 Broadway , Bayonne NJ 07002-3846. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Boghossian, Jack can be contacted via phone (973) 364-2682.Contact Information
Primary practice address
631 Broadway
Bayonne NJ 07002-3846
Phone: (973) 364-2682
Fax: (973) 364-1430
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | MA81581 | New Jersey |
Profile Details
| NPI number | 1083666010 |
|---|---|
| LBN Legal business name | Boghossian, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Mar 26th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083666010 | NPPES |
| New Jersey | MEDICAID | 4555104 |
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