Lisa Jean Boucher P.A.-C

NPI 1730285982 - Physician Assistant - 363A00000X

NPI Details
NPI 1730285982
Gender Female
Enumeration Date 09/15/2006
Last Updated 02/05/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
2000 E GUN HILL RD
BRONX NY, 10469-6016, US
Phone (718) 405-3534
Fax (718) 405-3501
Business Location
2000 E GUN HILL RD
BRONX NY, 10469-6016, US
Phone (718) 405-3534
Fax (718) 405-3501
Toxanomy
Taxonomy Code 363A00000X
License State New York
License Number 5606
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According to our database, Ms. Lisa Jean Boucher P.A.-C NPI is 1730285982, taxonomy code is 363A00000X and license number is 5606, license state is located at New York. Lisa Jean Boucher P.A.-C physically located at 2000 E Gun Hill Rd, Bronx NY, 10469-6016. NPI Number Lisa Jean Boucher P.A.-C has the Individual type.

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1730285982 NPI number is provided on an as is basis without warranty of any kind. 1730285982 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Jean Boucher P.A.-C are for informational purposes only.