Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F332068-1 | NY |
NPI | 1003148776 |
---|---|
Provider Name | Mrs. Kathleen J Boyle |
First Address | Harrison, NY 10528-3131 |
Second Address | Harrison, NY 10528-3131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2010 |
Last Update Date | 08/12/2015 |