Boucicault, Gertha

Boucicault, Gertha is an individual health care provider with primary practice located at 21211 102Nd Ave Apt. C4, Queens Village NY 11429-1106. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Boucicault, Gertha can be contacted via phone (718) 468-8298.

Contact Information

Primary practice address
21211 102Nd Ave Apt. C4 Queens Village NY 11429-1106
Phone: (718) 468-8298
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 573530 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F345182-01 New York

Profile Details

NPI number 1619285814
LBN Legal business name Boucicault, Gertha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2010
Last updated Jun 30th, 2023 - about 2 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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