Provider Demographics
NPI:1639336175
Name:BOYD-WOSCHINKO, GILLIAN (MD)
Entity type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:
Last Name:BOYD-WOSCHINKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 BAY AVE STE 300B
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1607
Mailing Address - Country:US
Mailing Address - Phone:973-798-4777
Mailing Address - Fax:201-523-9550
Practice Address - Street 1:311 BAY AVE STE 300B
Practice Address - Street 2:
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1607
Practice Address - Country:US
Practice Address - Phone:973-798-4777
Practice Address - Fax:201-523-9550
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251628207R00000X
NJ25MA09236900207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine