Provider Demographics
NPI:1225091358
Name:BOYT, KRISTIN M (PA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:BOYT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NH
Mailing Address - Zip Code:03870-2633
Mailing Address - Country:US
Mailing Address - Phone:207-838-6258
Mailing Address - Fax:
Practice Address - Street 1:70 FRANCIS ST
Practice Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL - CARDIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6134
Practice Address - Country:US
Practice Address - Phone:857-307-1945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1766363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ46941Medicare UPIN