Individual
ELISE BOUCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1000 10TH AVE, NEW YORK, NY 10019-1147
(315) 727-3051
Mailing address
2074 FRDRCK DGLS BLVD APT 2C, NEW YORK, NY 10026-3299
(315) 727-3051
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
350065
NY
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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