Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 016397 | NY |
NPI | 1023378304 |
---|---|
Provider Name | Mrs. Kira Margaret Boyle |
First Address | New York, NY 10011-5716 |
Second Address | New York, NY 10001-3816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2012 |
Last Update Date | 21/05/2012 |