Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MD048076L | PA |
NPI | 1013926922 |
---|---|
Provider Name | Richard Boulay |
First Address | Easton, PA 18045-5671 |
Second Address | Easton, PA 18045-5671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 21/01/2020 |