Basic Information
Provider Information
NPI: 1821434135
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOYLE
FirstName: SEAN
MiddleName: PATRICK
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 47 NEW SCOTLAND AVE
Address2: DEPARTMENT OF SURGERY
City: ALBANY
State: NY
PostalCode: 122083412
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 211 CHURCH ST
Address2:  
City: SARATOGA SPRINGS
State: NY
PostalCode: 128661003
CountryCode: US
TelephoneNumber: 5185873222
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2013
LastUpdateDate: 04/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X278565-1NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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