Individual
CYNTHIA M BOUSHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
5415 W GENESEE ST, SUITE 301, CAMILLUS, NY 13031-2162
(315) 487-8109
(315) 487-5680
Mailing address
5415 W GENESEE ST, SUITE 301, CAMILLUS, NY 13031-2162
(315) 487-8109
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F3327451
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02708547
—
NY
Enumeration date
02/09/2006
Last updated
08/17/2007
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