Provider Demographics
NPI:1700517323
Name:BOISJOLIE, TAYLOR ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ROSE
Last Name:BOISJOLIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1614
Mailing Address - Country:US
Mailing Address - Phone:413-427-7033
Mailing Address - Fax:
Practice Address - Street 1:30 NEW CROSSING RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3270
Practice Address - Country:US
Practice Address - Phone:413-427-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program