Provider Demographics
NPI:1578916169
Name:BOYLE, SUSAN (RRT)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HENRY MARSH RD
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-5759
Mailing Address - Country:US
Mailing Address - Phone:508-949-3636
Mailing Address - Fax:
Practice Address - Street 1:5 HENRY MARSH RD
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-5759
Practice Address - Country:US
Practice Address - Phone:508-949-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MART28912279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care