Boucher, Kevin E

Boucher, Kevin E is an sole proprietor health care provider with primary practice located at 5 Clinic Rd , Abington CT 06230-2005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Boucher, Kevin E can be contacted via phone (860) 974-0529.

Contact Information

Primary practice address
5 Clinic Rd Abington CT 06230-2005
Phone: (860) 974-0529
Fax: (860) 974-1029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 000211 Connecticut

Profile Details

NPI number 1992869523
LBN Legal business name Boucher, Kevin E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2006
Last updated Apr 19th, 2010 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1992869523 NPPES
Connecticut Other 4476899 AETNA
Connecticut Other 1770258-003 AETNA
Connecticut Other WIP019 AETNA
Connecticut Other 040000211CT-04 AETNA
Connecticut Other 051180 AETNA
Connecticut MEDICAID 001002112 AETNA

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