Boise, Marina

Boise, Marina is an individual health care provider with primary practice located at 5008 Brittonfield Pkwy Ste 700 , East Syracuse NY 13057-9249. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Boise, Marina can be contacted via phone (315) 472-7504.

Contact Information

Primary practice address
5008 Brittonfield Pkwy Ste 700 East Syracuse NY 13057-9249
Phone: (315) 472-7504
Fax: (315) 634-4677
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 020915 New York

Profile Details

NPI number 1932244969
LBN Legal business name Boise, Marina
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Oct 7th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932244969 NPPES
New York Other 020915 NYS LICENSE

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