Individual provider · NPI-1

Kaitlin Boehm, DO

Pediatrics, Pediatric Emergency Medicine · Mineola, NY

NPI number1033573522
StatusActive
Last updated in NPPESDec 28, 2023

Details

NPI
1033573522
Entity type
Individual (NPI-1)
Name
Kaitlin Boehm
Credential
DO
Sex
Female
Sole proprietor
No
Enumeration date
Apr 11, 2016
Certification date
Dec 28, 2023
Last updated
Dec 28, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080P0204X Pediatrics, Pediatric Emergency Medicine297765NYYes

Other names

  • Kaitlin Keenan (Former Name)

Practice location

259 1st St
Mineola, NY 11501-3957

Phone 516-663-8766

Mailing address

259 1st St
Mineola, NY 11501-3957

Phone 516-663-8766

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Pediatrics, Pediatric Emergency Medicine providers in Mineola, NY