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NPI Code Detail

MEDICARE: JONELLE BOATENG

MEDICARE: JONELLE BOATENG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramDE

General Provider Information

NPI Number : 1770432312
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONELLE BOATENG
Provider Business Mailing Address
First Line : 1200 N DUPONT HWY
Second Line : BOX 2477
City : DOVER
State : DE
Zip : 19901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 N DUPONT HWY
Second Line : BOX 2477
City : DOVER
State : DE
Zip : 19901
Country : US
Telephone Number : 917-517-9335
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ JONELLE BOATENG ” Practice Location

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