Basic Information
| Provider Information | |||||||||
| NPI: | 1649851189 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL BOYLE PH.D., INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5036 JERICHO TPKE STE 203 | ||||||||
| Address2: | |||||||||
| City: | COMMACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117252812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314625222 | ||||||||
| FaxNumber: | 6314625258 | ||||||||
| Practice Location | |||||||||
| Address1: | 5036 JERICHO TPKE STE 203 | ||||||||
| Address2: | |||||||||
| City: | COMMACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117252812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314625222 | ||||||||
| FaxNumber: | 6314625258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2021 | ||||||||
| LastUpdateDate: | 07/16/2021 | ||||||||
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| AuthorizedOfficialLastName: | BOYLE | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 6314625222 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
| NPICertificationDate: | 07/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.