Boller, Christopher George

Boller, Christopher George is an sole proprietor health care provider with primary practice located at 10819 Rockaway Blvd , South Ozone Park NY 11420-1034. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Boller, Christopher George can be contacted via phone (718) 845-2620.

Contact Information

Primary practice address
10819 Rockaway Blvd South Ozone Park NY 11420-1034
Phone: (718) 845-2620
Fax: (718) 845-9380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 072771-1 New York
Behavioral Health & Social Service Providers / Social Worker 104100000X 072771-1 New York

Profile Details

NPI number 1609921121
LBN Legal business name Boller, Christopher George
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 24th, 2007
Last updated Aug 24th, 2009 - about 15 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 1609921121 NPPES
New York MEDICAID 00072771
New York Other 072771-1

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