Provider Demographics
NPI:1851842819
Name:BOYLES, JOSALYN WINNIE-LARIE
Entity Type:Individual
Prefix:MS
First Name:JOSALYN
Middle Name:WINNIE-LARIE
Last Name:BOYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 411
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2323
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-664-7659
Practice Address - Street 1:2741 MACARTHUR RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-3632
Practice Address - Country:US
Practice Address - Phone:610-403-6000
Practice Address - Fax:610-403-6010
Is Sole Proprietor?:No
Enumeration Date:2016-10-14
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA55839207Q00000X
PAOA004935363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine