Provider Demographics
NPI:1922346386
Name:BOEY, GWENDOLYN L (RN)
Entity Type:Individual
Prefix:MS
First Name:GWENDOLYN
Middle Name:L
Last Name:BOEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 CABRINI BLVD
Mailing Address - Street 2:APT. 4H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3612
Mailing Address - Country:US
Mailing Address - Phone:212-927-8055
Mailing Address - Fax:
Practice Address - Street 1:255 CABRINI BLVD
Practice Address - Street 2:APT. 4H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3612
Practice Address - Country:US
Practice Address - Phone:212-927-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344299163W00000X
NJ26NR13712800163W00000X
PARN593390163W00000X
FL9277678163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse