Provider Demographics
NPI:1255955217
Name:BOYLAN, JAMES EDWARD (PA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDWARD
Last Name:BOYLAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2722
Mailing Address - Country:US
Mailing Address - Phone:484-818-1213
Mailing Address - Fax:
Practice Address - Street 1:138 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2722
Practice Address - Country:US
Practice Address - Phone:484-818-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant