Provider Demographics
NPI:1083758775
Name:BOYLE, MARIA P (MD,)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:P
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MD,
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Mailing Address - Street 1:260 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-6870
Mailing Address - Country:US
Mailing Address - Phone:973-578-4745
Mailing Address - Fax:973-578-8797
Practice Address - Street 1:200 BELLEVILLE TPKE
Practice Address - Street 2:
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6235
Practice Address - Country:US
Practice Address - Phone:201-998-5386
Practice Address - Fax:201-998-2973
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2020-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06254200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4508807Medicaid