Lisa Boule', CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F381165-1 Issued in NY

Practice address

2066 Richmond Avenue
1St Floor
Staten Island, NY 10314-3916

Phone

(718) 982-9001

Fax

(718) 982-9008

NPI assigned

Jun 14, 2007

Last updated

Aug 3, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Island Kids Pediatrics, P.C.

  • Pediatric Adolescent Medicine Physician
  • Staten Island, NY
  • NPI 1487792024
  NPD (past)
• Richmond Pediatrics, P.C.

  • Pediatrics Physician
  • Staten Island, NY
  • NPI 1972844322
  NPD (past)
• Center for Pediatric Medicine

  • Pediatrics Physician
  • Danbury, CT
  • NPI 1861530750
  NPD (past)
• The Center for Advanced Pediatrics, P.C

  • Pediatrics Physician
  • Norwalk, CT
  • NPI 1750305017
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1437353273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 RICHMOND AVENUE",
            "address_2": "1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143916",
            "telephone_number": "718-982-9001",
            "fax_number": "718-982-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 RICHMOND AVENUE",
            "address_2": "1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143916",
            "telephone_number": "718-982-9001",
            "fax_number": "718-982-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULE'",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381165-1",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "358860-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0024165610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Bottalico
• Yasmin Rose Botte, LMHC
• Julia Marie Bottiglieri
• Elie Bou Sanayeh, M.D.
• Victoria Boucard, OTR/L
• Micheline Boulis
• Catherine Boulos, DDS
• Engy Boulos, RPH
• Dominique Bourgelais, FNP-BC
• Sarah Bourgin, DO

• Pediatric Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.