Individual provider · Type 1 NPI

Johane Gildade Boursiquot, MD

General Practice Physician · Bronx, NY

NPI number 1275801219 Active

Practice location

2015 Grand Concourse
Bronx, NY 10453-4303

Call (718) 299-7295 Map

Fax (718) 299-6797

Mailing address

1436 Williamsbridge Rd
Bronx, NY 10461-2507

Other practice locations

  • 2015 Grand Concourse, Bronx, NY 10453-4303 · (718) 299-7295
  • 7924 Jamaica Ave, Woodhaven, NY 11421-1801 · (718) 805-0037
  • 150 Riverside Dr, New York, NY 10024-2298 · (646) 505-3500
  • 515 Madison Ave Ste 9083, New York, NY 10022-5403 · (718) 954-7338

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XMT205076 (PA)
General Practice Physician Primary 208D00000X277201 (NY)

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

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About NPI 1275801219

Johane Gildade Boursiquot, MD's National Provider Identifier is 1275801219, issued on Dec 6, 2011. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Bronx, NY. The record was last updated on Mar 19, 2021.