Individual provider · Type 1 NPI
Gary J. Bouchard, PA-C
Medical Physician Assistant · Greenlawn, NY
NPI number
1457505083
Active
Practice location
190 Broadway
Greenlawn, NY 11740-2120
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | MP 00002600 (NJ) |
| Medical Physician Assistant Primary | 363AM0700X | 003223 (NY) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Greenlawn
About NPI 1457505083
Gary J. Bouchard, PA-C's National Provider Identifier is 1457505083, issued on Nov 10, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Greenlawn, NY. The record was last updated on Jun 12, 2019.