Boucher, Desiree M

Boucher, Desiree M is an individual health care provider with primary practice located at 105 Storm Dr , Holtsville NY 11742-1912. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Boucher, Desiree M can be contacted via phone (631) 831-6040.

Contact Information

Primary practice address
105 Storm Dr Holtsville NY 11742-1912
Phone: (631) 831-6040
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1194082198
LBN Legal business name Boucher, Desiree M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2012
Last updated Apr 13th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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