MARIA BOULOS


Address: 711 Troy Schenectady Rd, Suite 114, Latham, NY 12110-2442
Phone: 5187861600

MARIA BOULOS (NPI# 1801973771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801973771
Entity Type Individual
Full Name MARIA BOULOS
Practice Address 711 Troy Schenectady Rd
Suite 114
Latham
NY 12110-2442
Mailing Address 711 Troy Schenectady Rd
Suite 201
Latham
NY 12110-2442
Practice Telephone 5187861600
Enumeration Date 2006-10-31
Last Update Date 2011-12-06
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085P0229X Radiology
Specialization: Pediatric Radiology
211666 NY Allopathic & Osteopathic Physicians
N 2085R0202X Radiology
Specialization: Diagnostic Radiology
211666 NY Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NY 01991033 05

Office Location

Street Address 711 TROY SCHENECTADY RD
SUITE 114
City LATHAM
State NY
Zip Code 12110-2442

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134115157 Junnong Tang Physical Medicine & Rehabilitation 711 Troy Schenectady Rd, Suite 207b, Latham, NY 12110-2442 2005-09-26
1841891678 Sarah Evans Physician Assistant 711 Troy Schenectady Rd, Latham, NY 12110-2442 2020-11-06
1598319881 Raelyn Passino Pharmacist 711 Troy Schenectady Rd, Latham, NY 12110-2442 2019-07-25
1720566623 Lori A George Counselor 711 Troy Schenectady Rd, Latham, NY 12110-2442 2018-08-02
1144760661 Katharine Campbell Occupational Therapist 711 Troy Schenectady Rd, Suite 216, Latham, NY 12110 2017-03-02
1083157051 Kyle Mckeighan Physical Therapist 711 Troy Schenectady Rd, Suite 214, Latham, NY 12110-2442 2016-11-23
1356883052 Diane Sweeney Physical Therapist 711 Troy Schenectady Rd, Suite 214, Latham, NY 12110-2442 2016-11-11
1730630294 Meghan T Brigham Nurse Practitioner 711 Troy Schenectady Rd, Suite 104, Latham, NY 12110-2442 2016-10-19
1720439243 Ashley Crews Physical Therapist 711 Troy Schenectady Rd, Suite 214, Latham, NY 12110-2442 2016-06-27
1639529712 Michael Lynch Radiology Practitioner Assistant 711 Troy Schenectady Rd, Suite 114, Latham, NY 12110-2442 2016-06-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154963973 Bayley Archinal Physical Therapist 711 Troy-schenectady Road, Ste 216, Latham, NY 12110 2019-10-14
1114410701 Kimberly A. Hostig Licensed Clinical Social Worker Pllc Clinic/Center 8 Stanley Cir Ste 11, Latham, NY 12110 2018-06-08
1710477260 Colleen Phillips Physical Therapist 711 Troy Schenectady Rd Ste 216, Latham, NY 12110 2018-05-10
1528574779 Deborah Cannon Specialist 33c Waterford Avenue East, Latham, NY 12110 2017-12-26
1730600149 Michael Navarrete Dentist 231 Wade Road Ext Unit 101, Latham, NY 12110 2017-07-06
1316499452 Colonie Asc LLC Clinic/Center 207 Troy-schenectady Rd, Colonie, NY 12110 2016-10-25
1720539950 Tania M Durante Pharmacist 1057 Troy-schenectady Rd, Latham, NY 12110 2016-10-24
1417344987 New York Epilepsy Medicine, PC Clinic/Center 3 Lear Jet Ln Ste 203, Latham, NY 12110 2015-04-22
1346664752 Lauren Gannon Registered Nurse 95 Forts Ferry Road, Latham, NY 12110 2014-02-06
1649522756 Natasha Kapsaroff-ruiz Nurse Practitioner 654 Watervliet Shaker Rd, Latham, NY 12110 2012-10-12
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Taxonomy Information

Taxonomy Code 2085P0229X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Pediatric Radiology

Taxonomy Definition

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053495861 Lisa Ribons Radiology 711 Troy Schenectady Rd, Suite 114, Latham, NY 12110-2442 2006-10-25
1619057676 Barbara Dangman Radiology Crhp-711 Troy-schenectady Road, Suite 114, Latham, NY 12110 2006-10-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1477112191 Peter F Temsah Radiology 6610 Grand Ave Apt 2a, Maspeth, NY 11378-2501 2019-06-06
1194123265 Henry Arthur Pritzker Radiology 1205 Fountainview Dr, Monsey, NY 10952-2863 2014-12-05
1083905327 Michael John Baad Radiology 525 E 68th St #141, Newyork-presbyterian/weill Cornell Medical College, New York, NY 10065-4885 2011-04-20
1164494225 Antoine Rabinowitz Radiology 710 Guion Dr, Mamaroneck, NY 10543-4117 2006-02-03
1154324184 Terri Antrenase Williams-weekes Radiology 47 New Scotland Ave, Radiology Department, Albany, NY 12208-3412 2005-05-23
1700410065 Nadia Sultan Radiology 601 Elmwood Ave, Rochester, NY 14642-0001 2020-02-26
1679903579 Dia Invision Health Radiology 100 College Pkwy, Suite 180, Williamsville, NY 14221-6800 2013-11-14
1417394529 Irene Sher Radiology 111 E 210th St, Bronx, NY 10467-2401 2013-05-30
1053758250 Sara Cohen Radiology 525 E 68th St, New York, NY 10065 2013-05-29
1922353689 Anand Shyamcharan Majmudar Radiology 750 East Adams St, Syracuse, NY 13210-2306 2012-07-19
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Competitor

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City LATHAM
Zip Code 12110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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