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General NPI Number Information
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NPI Number | 1922150846
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Entity Type | Organization
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Legal Business Name | SEAN P. BOYLE
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2523 STATE ROUTE 31
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City | WEEDSPORT
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State | NY
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Zip | 13166-3202
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Country | US
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Telephone | 315-834-6541
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Fax | 315-834-6919
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Provider Business Mailing Address
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Address Line | 2523 STATE ROUTE 31 P O BOX 1095
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City | WEEDSPORT
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State | NY
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Zip | 13166-3202
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Country | US
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Telephone | 315-834-6541
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Fax | 315-834-6919
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SEAN P BOYLE
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Credential | MD
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Telephone | 315-834-6541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 194822
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License Number State | NY
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