Organization
NYU MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORLAND KENTON BOUCHER P.A. (PHYSICIAN ASSISTANT)
12122637300
Entity
Organization
Contact information
Practice address
462 1ST AVE, NEW YORK, NY 10016-9196
(121) 256-2222
Mailing address
880 E 34TH ST, BROOKLYN, NY 11210-2731
(718) 434-2502
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
010398-1
NY
Other
Enumeration date
02/28/2007
Last updated
08/22/2020
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