# GEORGE BOUCHER MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982907614
- **Authorized official:** DR. GEORGE P. BOUCHER MD (PRESIDENT)
- **Authorized official phone:** (716) 882-0684

## Contact information

- **Practice address:** 462 GRIDER ST, BUFFALO, NY 14215-3021
- **Practice address phone:** (716) 898-5540
- **Mailing address:** 680 CRESCENT AVE, BUFFALO, NY 14216-3403
- **Mailing address phone:** (716) 882-0684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 234234 | NY | Yes |

## Other

- **Enumeration date:** 12/20/2010
- **Last updated:** 12/20/2010