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NPI Code Detail

MEDICARE: DR. THOMAS MATTHEW BOES MD

MEDICARE: DR. THOMAS MATTHEW BOES MD
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
12084N0400XNeurology Physician263713NY

General Provider Information

NPI Number : 1174757421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS MATTHEW BOES MD
Provider Business Mailing Address
First Line : 102 RIVERS EDGE RD OFC 1525A
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-766-5870
Fax Number :
Provider Business Practice Location Address
First Line : 102 RIVERS EDGE RD OFC 1525A
Second Line :
City : NEW YORK
State : NY
Zip : 10035-1163
Country : US
Telephone Number : 646-766-5870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2009
Last Update Date : 04/06/2023

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