Provider Demographics
NPI:1336290642
Name:O'BOYLE KOST, PATRICIA N (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:N
Last Name:O'BOYLE KOST
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PATRICIA
Other - Middle Name:N
Other - Last Name:O'BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:409 BOGERT RD
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1844
Mailing Address - Country:US
Mailing Address - Phone:201-262-0199
Mailing Address - Fax:201-262-0252
Practice Address - Street 1:409 BOGERT RD
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1844
Practice Address - Country:US
Practice Address - Phone:201-262-0199
Practice Address - Fax:201-262-0252
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00297100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222716803OtherTIN
NJ222716803OtherTIN