LISSA BOILEAU NPI 1174840367

NPI Information

  • NPI: 1174840367
  • Provider Name: LISSA BOILEAU
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 2 THE PLZ
    RONKONKOMA, NY
    ZIP 11779
  • Phone: (631) 676-2765

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NPI Details

Lissa Boileau is a psychiatric/mental health nurse practitioner in Ronkonkoma, NY. Lissa Boileau NPI is 1174840367. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2 THE PLZ
RONKONKOMA, NY
ZIP 11779-849
Phone: (631) 676-2765

The enumeration date for this NPI number is 4/27/2010 and was last updated on 2/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse22609284NEW YORKNo
2363LP0808XNurse PractitionerPsychiatric/Mental Health406771NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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