Organization
RAQUEL BOUTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL MARIE BOUTON (LPN)
(631) 828-2882
Entity
Organization
Contact information
Practice address
2 DOMINO WAY, MOUNT SINAI, NY 11766-2715
(631) 828-2882
Mailing address
2 DOMINO WAY, MOUNT SINAI, NY 11766-2715
(631) 828-2882
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
10303300
NY
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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