Individual
TARA BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
223 N MAIN ST STE 103, CAPE MAY COURT HOUSE, NJ 08210-2182
(609) 463-2273
(609) 778-2358
Mailing address
1 FEDERAL ST STE 200, CAMDEN, NJ 08103-1088
(848) 288-6935
(732) 790-0107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00462600
NJ
363A00000X
Physician Assistant
MA052284
PA
Other
Enumeration date
04/20/2007
Last updated
03/17/2025
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