Provider Demographics
NPI:1033104138
Name:BOYER, SUE ELLEN F (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUE ELLEN
Middle Name:F
Last Name:BOYER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CAPSTAN STREET
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1629
Mailing Address - Country:US
Mailing Address - Phone:609-607-0037
Mailing Address - Fax:
Practice Address - Street 1:500 RIVER AVENUE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-0723
Practice Address - Country:US
Practice Address - Phone:732-942-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00046700231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist