Healthcare Provider Details

I. General information

NPI: 1760089924
Provider Name (Legal Business Name): EMILY BOYKO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 TRAPELO RD # 2
BELMONT MA
02478-1417
US

IV. Provider business mailing address

413 TRAPELO RD 2
BELMONT MA
02478
US

V. Phone/Fax

Practice location:
  • Phone: 617-932-1027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: