GERTHA BOUCICAULT

Nurse Practitioner - Family

Active Individual
NPI: 1619285814

Practice Address

21211 102ND AVE
APT. C4
Queens Village, NY 11429

Phone: (718) 468-8298

Specialties

Specialty Code Primary License
Registered Nurse 163W00000X No 573530 (NY)
Nurse Practitioner - Family 363LF0000X Yes F345182-01 (NY)

Frequently Asked Questions

NPI 1619285814 is the National Provider Identifier for GERTHA BOUCICAULT, a Nurse Practitioner - Family provider located in Queens Village, NY. This NPI was enumerated on September 22, 2010.
GERTHA BOUCICAULT practices at 21211 102ND AVE, APT. C4, Queens Village, NY 11429.

Quick Facts

NPI
1619285814
Type
Individual
Enumerated
Sep 22, 2010
Last Updated
Jun 30, 2023

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