Provider Demographics
NPI:1366618266
Name:BOIANO, MARIA ANNA (DO)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANNA
Last Name:BOIANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 55 NORTH ROUTE 9W
Mailing Address - Street 2:MEDICAL STAFF OFFICE
Mailing Address - City:WEST HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10993-1195
Mailing Address - Country:US
Mailing Address - Phone:845-786-4062
Mailing Address - Fax:
Practice Address - Street 1:51 N ROUTE 9W
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993-1127
Practice Address - Country:US
Practice Address - Phone:845-786-4062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252217208100000X
NJ25MB09295000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation