Donna Jean Boulay
Individual provider Active NPI Geriatric Physical Therapist · Mystic, CT
NPI 1285306233 · NPPES record last updated Sep 29, 2021
Key facts
- NPI
- 1285306233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Geriatric Physical Therapist 2251G0304X
- Practice address
- 44 Maritime Dr
Mystic, CT 06355-1958 - Phone
- (401) 829-6104
- NPI assigned
- Sep 29, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | Yes |
Addresses
Primary practice location
44 Maritime Dr
Mystic, CT 06355-1958
Mailing address
44 Maritime Dr
Mystic, CT 06355-1958
Other providers in Mystic, CT
- Blue Whale Counseling and Center for Healing
- Thomas March Blum
- Julie Boardsen-Bean
- Rosemary Catherine Bontempi
- Elena Bortan
- Tiffany Bradley
- Howard Brensilver
- Barbara Jean Bronson
- Daniel Stubbs Brown
- Meghan B Brunnock
All providers in Mystic, CT · Geriatric Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.