Provider Demographics
NPI:1750031001
Name:BOYLE, VINCENT JOSEPH
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:JOSEPH
Last Name:BOYLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 ROUTE 145
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-2146
Mailing Address - Country:US
Mailing Address - Phone:518-755-7455
Mailing Address - Fax:
Practice Address - Street 1:325 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-1902
Practice Address - Country:US
Practice Address - Phone:518-828-9446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker