Provider Demographics
NPI:1649969254
Name:BOSO, RANNY M
Entity type:Individual
Prefix:MS
First Name:RANNY
Middle Name:M
Last Name:BOSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 W 197TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-2342
Mailing Address - Country:US
Mailing Address - Phone:929-575-1118
Mailing Address - Fax:
Practice Address - Street 1:88 W 197TH ST APT 4C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-2342
Practice Address - Country:US
Practice Address - Phone:929-575-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst