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General NPI Number Information
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NPI Number | 1033104138
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Entity Type | Individual
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Provider Name | SUE ELLEN F. BOYER AUD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 500 RIVER AVENUE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-0723
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Country | US
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Telephone | 732-942-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 9 CAPSTAN STREET
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City | BARNEGAT
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State | NJ
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Zip | 08005-1629
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Country | US
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Telephone | 609-607-0037
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 41YA00046700
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License Number State | NJ
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