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General NPI Number Information
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NPI Number | 1952656415
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Entity Type | Individual
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Provider Name | DEBORAH J BOUSQET M.S. OF ED
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Gender | Female
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 26 TODD CT
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4224
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Country | US
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Telephone | 631-553-9461
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Fax | 631-427-1850
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Provider Business Mailing Address
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Address Line | 26 TODD CT
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-4224
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Country | US
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Telephone | 631-553-9461
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Fax | 631-427-1850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NY
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