Provider Demographics
NPI:1588294623
Name:BOYLE, RACHEL C
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:BOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-273 WAIKALANI DR APT D1002
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3524
Mailing Address - Country:US
Mailing Address - Phone:973-634-1774
Mailing Address - Fax:
Practice Address - Street 1:800 S BERETANIA ST # 300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5703
Practice Address - Country:US
Practice Address - Phone:808-380-5183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAT-253204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine