Healthcare Provider Details

I. General information

NPI: 1811990948
Provider Name (Legal Business Name): DEWEY BOYER
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 CHAMPLIN AVE
NEW HARTFORD NY
13413-1068
US

IV. Provider business mailing address

PO BOX 2004
EAST SYRACUSE NY
13057-4504
US

V. Phone/Fax

Practice location:
  • Phone: 315-624-6222
  • Fax: 315-624-6308
Mailing address:
  • Phone: 315-362-5285
  • Fax: 315-445-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number123806
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number126806
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: