Gertha Boucicault
NPI #1619285814 in Queens Village, New York
Provider Information
- NPI Number
- 1619285814
- Entity Type
- Individual
- Name
- Gertha Boucicault
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Sep 22, 2010
- Last Updated
- Jun 30, 2023
Practice Location
- Address
- 21211 102ND AVE
- Address 2
- APT. C4
- City
- Queens Village
- State
- New York
- ZIP Code
- 11429-1106
- Phone
- (718) 468-8298
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse |
| Nurse Practitioner - Family — Family |
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