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NPI Code Detail

MEDICARE: KATHLEEN BOYANSKI

MEDICARE: KATHLEEN BOYANSKI
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
1225100000XPhysical Therapist0125901NY

General Provider Information

NPI Number : 1205094331
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN BOYANSKI
Provider Business Mailing Address
First Line : PO BOX 177
Second Line :
City : BLAUVELT
State : NY
Zip : 10913-0177
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 68 HOOVER ST
Second Line :
City : BLAUVELT
State : NY
Zip : 10913-1513
Country : US
Telephone Number : 646-924-6628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 03/19/2015

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Directions to “ KATHLEEN BOYANSKI ” Practice Location

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