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NPI Code Detail

MEDICARE: MRS. CONCETTA ANN BOICE RN

MEDICARE: MRS. CONCETTA ANN BOICE RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse423340-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104000470
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CONCETTA ANN BOICE RN
Provider Business Mailing Address
First Line : 79 GLENRIDGE RD
Second Line :
City : GLENVILLE
State : NY
Zip : 12302-4528
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 556 CLINTON AVE S
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-1105
Country : US
Telephone Number : 585-442-8422
Fax Number : 585-442-8494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2007
Last Update Date : 08/22/2022

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