Provider Demographics
NPI:1811993272
Name:BOEHLER, BARBARA J (NP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:BOEHLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 MAIN STREET
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-839-3057
Mailing Address - Fax:716-839-1477
Practice Address - Street 1:4510 MAIN STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-839-3057
Practice Address - Fax:716-839-1477
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMB0054495363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS59406Medicare UPIN
NYBB5317Medicare ID - Type Unspecified