=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912049297
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARA ANNE BOAS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2007
-----------------------------------------------------
Last Update Date | 08/11/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 479 ROUTE 79 SUITE 15
-----------------------------------------------------
City | MORGANVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07751-4061
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-591-2580
-----------------------------------------------------
Fax | 732-591-1525
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 MAIN ST
-----------------------------------------------------
City | MATAWAN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07747-3230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-688-6416
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00647000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------