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NPI Code Detail

MEDICARE: EMILY BOUCHER

MEDICARE: EMILY BOUCHER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1912858895
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY BOUCHER
Provider Business Mailing Address
First Line : 99 SUMNER ST PH 623
Second Line :
City : BOSTON
State : MA
Zip : 02128-4985
Country : US
Telephone Number : 401-324-9100
Fax Number :
Provider Business Practice Location Address
First Line : 513 BROADWAY
Second Line :
City : NEWPORT
State : RI
Zip : 02840-1471
Country : US
Telephone Number : 401-324-9100
Fax Number : 401-380-8260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ EMILY BOUCHER ” Practice Location

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