Healthcare Provider Details

I. General information

NPI: 1457277691
Provider Name (Legal Business Name): ERIC SCOTT BOYLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 INDUSTRIAL BLVD
PLATTSBURGH NY
12901-1910
US

IV. Provider business mailing address

29 FOXFIRE DR
PLATTSBURGH NY
12901-3113
US

V. Phone/Fax

Practice location:
  • Phone: 518-324-8603
  • Fax:
Mailing address:
  • Phone: 518-324-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number004014-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: