Mrs. Patricia Boucher
Adolescent Medicine
65 Libby St
Brockton
, Massachusetts 02302-2949
Mrs. Patricia Boucher
Adolescent Medicine
65 Libby St
Brockton
, Massachusetts 02302-2949
(508) 584-6060
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Mrs. Patricia Boucher
- 65 Libby St
- Brockton, MA
- Zip : 02302-2949
- Phone : (508) 584-6060
Second Address
- Mrs. Patricia Boucher
- 65 Libby St
- Brockton, MA
- Zip : 02302-2949
- Phone : (508) 584-6060
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | RN172200 | MA |
National Provider Identifier
| NPI | 1194037119 |
|---|---|
| Provider Name | Mrs. Patricia Boucher |
| First Address | Brockton, MA 02302-2949 |
| Second Address | Brockton, MA 02302-2949 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/07/2010 |
| Last Update Date | 07/07/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.