MEDICARE: DR. KRYSTENE BOYLE DIPAOLA M.D.

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	207VE0102X	Reproductive Endocrinology Physician	35089505	OH
2	207V00000X	Obstetrics & Gynecology Physician	35-089505	OH
3	207VE0102X	Reproductive Endocrinology Physician	281913	NY

General Provider Information

NPI Number	:	1538215371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRYSTENE BOYLE DIPAOLA M.D.

Provider Business Mailing Address
First Line	:	1623 MILITARY RD # 367
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14304-1745
Country	:	US
Telephone Number	:	716-243-8377
Fax Number	:	716-796-0768

Provider Business Practice Location Address
First Line	:	1408 SWEET HOME RD # 9-10
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-2783
Country	:	US
Telephone Number	:	716-243-8377
Fax Number	:	716-796-0768

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	06/12/2019

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