Andrew Boyanowski, MT, MBA

Primary specialty

Medical TechnologistTaxonomy code 246QM0706X

License

213715 Issued in PA

Practice address

104 Heller Hill Rd
Laceyville, PA 18623-6669

Phone

(570) 665-9149

NPI assigned

May 4, 2023

Last updated

May 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration, Medical Technician

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1306535414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HELLER HILL RD",
            "city": "LACEYVILLE",
            "state": "PA",
            "postal_code": "186236669",
            "telephone_number": "570-665-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HELLER HILL RD",
            "city": "LACEYVILLE",
            "state": "PA",
            "postal_code": "186236669",
            "telephone_number": "570-665-9149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N Gould St",
            "address_purpose": "LOCATION",
            "city": "Sheridan",
            "state": "WY",
            "postal_code": "828016317",
            "country_code": "US",
            "telephone_number": "570-665-9149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYANOWSKI",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "MT, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PA",
            "license": "213715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Ann Cunningham, PHARMD
• Theresa Marie Hails, RN, IBCLC
• Laceyville Ambulance Association
• Lechs Pharmacy
• Physiciancare, PC

• Medical Technologist in Laceyville, PA
• Providers in Laceyville, PA by specialty
• Medical Technologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.