Healthcare Provider Details

I. General information

NPI: 1134049182
Provider Name (Legal Business Name): JESSICA BOYCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 E MAIN ST
PATCHOGUE NY
11772-3105
US

IV. Provider business mailing address

10 SUNSET DR
BELLPORT NY
11713-1147
US

V. Phone/Fax

Practice location:
  • Phone: 631-905-7934
  • Fax:
Mailing address:
  • Phone: 631-905-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: