Individual provider · Type 1 NPI

Desiree M. Boucher

Specialist · Holtsville, NY

NPI number 1194082198 Active

Practice location

105 Storm Dr
Holtsville, NY 11742-1912

Call (631) 831-6040 Map

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1194082198

Desiree M. Boucher's National Provider Identifier is 1194082198, issued on Apr 13, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Holtsville, NY. The record was last updated on Apr 13, 2012.