Provider Demographics
NPI:1821863416
Name:BOIMA, QUINCY VARNEY
Entity Type:Individual
Prefix:
First Name:QUINCY
Middle Name:VARNEY
Last Name:BOIMA
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 1:43 DOBEK RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1311
Mailing Address - Country:US
Mailing Address - Phone:860-801-3838
Mailing Address - Fax:
Practice Address - Street 1:43 DOBEK RD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-1311
Practice Address - Country:US
Practice Address - Phone:860-801-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant