Individual
ELISHA BOUKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3612 36TH AVE, ASTORIA, NY 11106-1334
(718) 819-8623
(347) 448-6213
Mailing address
15919 84TH DR, JAMAICA, NY 11432-2528
(917) 855-4155
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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