| Doctor Name: | LISA M BOSCO |
| NPI Number: | 1871924654 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | 26NJ00425300 |
| Business Practice Address: | 1900 Union Valley Rd Suite 303 Hewitt, NJ - 074213024 |
| Business Phone Number: | 9737068535 |
| Business Fax Number: | |
| Mailing Address: | 9 Jenny Ln, WAYNE |
| State: | NJ |
| Postal Code: | 074701940 |
| Phone Number: | 9737877775 |
| Fax Number: | |
| NPI Enumeration Date: | 12/04/2013 |
| NPI Last Update Date: | 02/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NJ00425300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |