Provider Demographics
NPI:1871059279
Name:BOYLE, JAMES III (MA, LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:BOYLE
Suffix:III
Gender:M
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2599
Mailing Address - Country:US
Mailing Address - Phone:908-296-4567
Mailing Address - Fax:908-354-4246
Practice Address - Street 1:1085 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205-2599
Practice Address - Country:US
Practice Address - Phone:908-296-4567
Practice Address - Fax:908-354-4246
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001429002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer