Individual
DR. NICOLE COLETTE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
361 BROADWAY, KINGSTON, NY 12401-5151
(462) 501-9636
Mailing address
98 UPPER WHITFIELD RD, ACCORD, NY 12404-5930
(646) 250-1963
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
263528
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02694333
—
NY
Enumeration date
07/09/2006
Last updated
07/15/2025
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