MRS. Desiree M Boucher
NPI #1194082198 in Holtsville, New York
Provider Information
- NPI Number
- 1194082198
- Entity Type
- Individual
- Name
- MRS. Desiree M Boucher
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Enumeration Date
- Apr 13, 2012
- Last Updated
- Apr 13, 2012
Practice Location
- Address
- 105 STORM DR
- City
- Holtsville
- State
- New York
- ZIP Code
- 11742-1912
- Phone
- (631) 831-6040
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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