Provider Demographics
NPI:1184906927
Name:BOYLE, TARA JOY (PHARMD)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:JOY
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 22ND ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1203
Mailing Address - Country:US
Mailing Address - Phone:202-776-9084
Mailing Address - Fax:202-776-0969
Practice Address - Street 1:1217 22ND ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1203
Practice Address - Country:US
Practice Address - Phone:202-776-9084
Practice Address - Fax:202-776-0969
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209988183500000X
DCPH100000875183500000X
PARP445232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist