Basic Information
| Provider Information | |||||||||
| NPI: | 1740810423 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOYLE | ||||||||
| FirstName: | ERINA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2496 BELLMORE AVE | ||||||||
| Address2: | |||||||||
| City: | BELLMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117104304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173718699 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2200 NORTHERN BLVD STE 112 | ||||||||
| Address2: | |||||||||
| City: | GREENVALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115481220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164846777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/22/2020 | ||||||||
| LastUpdateDate: | 01/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | F344594-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.