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Individual

ANTHONY BOUTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6175
Mailing address
2201 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1859
(516) 572-6175

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
195825
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01589940
NY
Enumeration date
06/01/2006
Last updated
07/08/2007
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