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Individual
MARY JANE BOULEY
Active
Individual
MARY JANE BOULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016481
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103351FT
PREFERRED CARE
NY
01
—
7024316
AETNA
NY
01
—
P010016481
BLUE CHOICE
NY
01
—
P011016481
BLUE CROSS BLUE SHIELD
NY
Enumeration date
01/25/2006
Last updated
08/20/2008
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