Provider Demographics
NPI:1538215371
Name:DIPAOLA, KRYSTENE BOYLE (MD)
Entity type:Individual
Prefix:DR
First Name:KRYSTENE
Middle Name:BOYLE
Last Name:DIPAOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KRYSTENE
Other - Middle Name:
Other - Last Name:BOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1623 MILITARY RD # 367
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-1745
Mailing Address - Country:US
Mailing Address - Phone:716-243-8377
Mailing Address - Fax:716-796-0768
Practice Address - Street 1:1408 SWEET HOME RD # 9-10
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14228-2783
Practice Address - Country:US
Practice Address - Phone:716-243-8377
Practice Address - Fax:716-796-0768
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089505207VE0102X
OH35-089505207V00000X
NY281913207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2734063Medicaid
OH2734063Medicaid