Individual
CARIDAD BOUCICAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 BANK AVE, SMITHTOWN, NY 11787-2703
(631) 265-5300
(516) 570-4099
Mailing address
17 BANK AVE, SMITHTOWN, NY 11787-2703
(631) 265-5300
(516) 570-4099
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
261208-1
NY
Other
Enumeration date
05/14/2010
Last updated
04/19/2022
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