Provider Demographics
NPI:1306868971
Name:BOSCO, F PAUL (MSW)
Entity type:Individual
Prefix:MR
First Name:F
Middle Name:PAUL
Last Name:BOSCO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 DARNAY LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4111
Mailing Address - Country:US
Mailing Address - Phone:302-994-8472
Mailing Address - Fax:
Practice Address - Street 1:1400 PEOPLES PLZ STE 204
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5708
Practice Address - Country:US
Practice Address - Phone:302-832-1282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100001061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02473Medicare PIN
DEG02473A06Medicare PIN