Boulis, Matthew
Boulis, Matthew is an sole proprietor health care provider with primary practice located at 2099 New Albany Rd , Cinnaminson NJ 08077. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Boulis, Matthew can be contacted via phone (856) 829-5545.Contact Information
Primary practice address
2099 New Albany Rd
Cinnaminson NJ 08077
Phone: (856) 829-5545
Fax: (856) 829-9268
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MA22830 | New Jersey |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD-007664-E | Pennsylvania |
Profile Details
| NPI number | 1245252394 |
|---|---|
| LBN Legal business name | Boulis, Matthew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245252394 | NPPES |
| New Jersey | MEDICAID | 2381605 |
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