Provider Demographics
NPI:1972538494
Name:BOEGLIN, EUGENE (DPT)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:BOEGLIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 BLUE HILLS PKWY
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1535
Mailing Address - Country:US
Mailing Address - Phone:617-696-1974
Mailing Address - Fax:617-696-6251
Practice Address - Street 1:191 BLUE HILLS PKWY
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-1535
Practice Address - Country:US
Practice Address - Phone:617-696-1974
Practice Address - Fax:617-696-6251
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA62052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA392979Medicaid
MAY66202Medicare ID - Type Unspecified