Provider Demographics
NPI:1427651371
Name:BOYCE, ROBERT (NP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BOYCE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 BOWERY # 636
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4727
Mailing Address - Country:US
Mailing Address - Phone:833-427-7969
Mailing Address - Fax:347-905-4465
Practice Address - Street 1:119 W 124TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4920
Practice Address - Country:US
Practice Address - Phone:212-932-2824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily