Individual
DR. PHILLIP M BOISELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-1948
Mailing address
3 JOY STREET, UNIT 2, BOSTON, MA 02108-1204
(617) 894-6651
(617) 894-6651
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
336582
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336582
NEW YORK STATE MEDICAL LICENSE
NY
Enumeration date
05/18/2006
Last updated
08/14/2025
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