Basic Information
| Provider Information | |||||||||
| NPI: | 1366618266 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOIANO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | ANNA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 51 55 NORTH ROUTE 9W | ||||||||
| Address2: | MEDICAL STAFF OFFICE | ||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109931195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864062 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 51 N ROUTE 9W | ||||||||
| Address2: | MEDICAL STAFF OFFICE | ||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109931127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864062 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2008 | ||||||||
| LastUpdateDate: | 06/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 252217 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 25MB09295000 | NJ | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.