Provider Demographics
NPI:1154387587
Name:BOYLE, SHERI LEE (PT)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:LEE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:SHERI
Other - Middle Name:LEE
Other - Last Name:ZAVASKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1201B N CHURCH ST
Mailing Address - Street 2:STE 307
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1453
Mailing Address - Country:US
Mailing Address - Phone:570-455-7108
Mailing Address - Fax:570-455-8835
Practice Address - Street 1:1201B N CHURCH ST
Practice Address - Street 2:STE 307
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1453
Practice Address - Country:US
Practice Address - Phone:570-455-7108
Practice Address - Fax:570-455-8835
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT007220L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA820634OtherFIRST PRIORITY
2225204OtherFIRST HEALTH
23023BOtherHEALTH AMERICA
PA50038361OtherCAPITAL BLUE CROSS
PA74393BOtherBLUE SHIELD
PA74393BOtherBLUE SHIELD