Provider Demographics
NPI:1720168347
Name:BOSIDE, NEIL N (MD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:N
Last Name:BOSIDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 EAST PUTNAM AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RIVERSIDE
Mailing Address - State:CT
Mailing Address - Zip Code:06878
Mailing Address - Country:US
Mailing Address - Phone:203-637-0057
Mailing Address - Fax:203-637-3280
Practice Address - Street 1:1200 EAST PUTNAM AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RIVERSIDE
Practice Address - State:CT
Practice Address - Zip Code:06878
Practice Address - Country:US
Practice Address - Phone:203-637-0057
Practice Address - Fax:203-637-3280
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-01-02
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Provider Licenses
StateLicense IDTaxonomies
CT035452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5452414OtherAETNA US HEALTHCARE
P479423OtherOXFORD
035452OtherCONNECTICARE
7730396002OtherCIGNA
CT010035452CT01OtherANTHEM BLUE CROSS
0V9649OtherHEALTH NET
78467OtherEMPIRE BLUE CROSS OF NY
CT010035452CT01OtherANTHEM BLUE CROSS