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NPI Code Detail

MEDICARE: MRS. ALLISON BOYANOVSKI RPA-C

MEDICARE: MRS. ALLISON BOYANOVSKI RPA-C
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
1363AS0400XSurgical Physician Assistant25MP000798NJ

General Provider Information

NPI Number : 1235136318
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALLISON BOYANOVSKI RPA-C
Provider Business Mailing Address
First Line : 186 WAYNE ST
Second Line : 324D
City : JERSEY CITY
State : NJ
Zip : 07302-5407
Country : US
Telephone Number : 732-925-6431
Fax Number : 732-225-4551
Provider Business Practice Location Address
First Line : 355 GRAND ST
Second Line : SURGERY DEPARTMENT
City : JERSEY CITY
State : NJ
Zip : 07302-4321
Country : US
Telephone Number : 201-915-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 08/14/2012

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Directions to “ MRS. ALLISON BOYANOVSKI RPA-C” Practice Location

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