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Gertha Boucicault
NPI 1619285814 · on the registry since 2010
Practice
- Address
- 21211 102nd Ave
Apt. C4
Queens Village, NY 11429 - Phone
- (718) 468-8298
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Also registered as
- 163W00000X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-06-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York