Provider Demographics
NPI:1336718980
Name:BOYLE, LILY CAMPANILE (PA)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:CAMPANILE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3411
Mailing Address - Country:US
Mailing Address - Phone:401-447-7372
Mailing Address - Fax:
Practice Address - Street 1:727 EAST AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6185
Practice Address - Country:US
Practice Address - Phone:401-725-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant