Healthcare Provider Details

I. General information

NPI: 1780500108
Provider Name (Legal Business Name): JULIET NAIDENE BOONE M.S. SPEC.ED, MSIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SHERWOOD LN
POUGHKEEPSIE NY
12601-6201
US

IV. Provider business mailing address

1 SHERWOOD LN
POUGHKEEPSIE NY
12601-6201
US

V. Phone/Fax

Practice location:
  • Phone: 845-702-5749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number798217
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: