Individual provider · NPI-1

Dr. Kevin E Boucher, D.O.

Family Medicine · Abington, CT

NPI number1992869523
StatusActive
Last updated in NPPESApr 19, 2010

Details

NPI
1992869523
Entity type
Individual (NPI-1)
Name
Dr. Kevin E Boucher
Credential
D.O.
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 20, 2006
Last updated
Apr 19, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine000211CTYes

Practice location

5 Clinic Rd
Abington, CT 06230-2005

Phone 860-974-0529 · Fax 860-974-1029

Mailing address

5 Clinic Rd
Abington, CT 06230-2005

Phone 860-974-0529 · Fax 860-974-1029

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