Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1285152405 |
---|---|
Provider Name | Michael Rocco Boino |
First Address | New York, NY 10020-1201 |
Second Address | New York, NY 10020-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2017 |
Last Update Date | 08/09/2017 |