Basic Information
| Provider Information | |||||||||
| NPI: | 1811990948 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BOYER | ||||||||
| FirstName: | DEWEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2004 | ||||||||
| Address2: | |||||||||
| City: | EAST SYRACUSE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130574504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153625285 | ||||||||
| FaxNumber: | 3154452936 | ||||||||
| Practice Location | |||||||||
| Address1: | 1656 CHAMPLIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW HARTFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134131068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3156246222 | ||||||||
| FaxNumber: | 3156246308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 123806 | NY | X | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 126806 | NY | X | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.