MEDICARE: MR. TROY J BOYLE PHD

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
1	1041C0700X	Clinical Social Worker	091712	NY

General Provider Information

NPI Number	:	1225059058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TROY J BOYLE PHD

Provider Business Mailing Address
First Line	:	125 BROAD ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10004-2400
Country	:	US
Telephone Number	:	917-572-3675
Fax Number	:

Provider Business Practice Location Address
First Line	:	6136 MISSION GORGE RD
Second Line	:	SUITE 115
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-3494
Country	:	US
Telephone Number	:	917-572-3675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	11/12/2024

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