Laurie J Boe, MS, ATC
Individual provider Active NPI Athletic Trainer · Waldwick, NJ
NPI 1689781973 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689781973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 25MT001114000 (NJ)
- Practice address
- 155 Wyckoff Ave
Waldwick, NJ 07463-1434 - Phone
- (201) 652-9000
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT001114000 | NJ | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 25MT001114000 | NJ | Yes |
Addresses
Primary practice location
155 Wyckoff Ave
Waldwick, NJ 07463-1434
Mailing address
12 Valley St
Hawthorne, NJ 07506-2018
Phone (973) 949-3393
Other providers in Waldwick, NJ
- Bergen Alliance Counseling Services LLC
- John J Beronio
- Dipansh Atulbhai Bhavsar
- Patricia Billotti
- Dana Boccellari
- Alice M Bontempo
- Lisa Bucco
- James Burns III
- Jaclyn A. Calem-Grunat
- Lacie J Callari
All providers in Waldwick, NJ · Athletic Trainer in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.