Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edjeanine Boucicault, LPN

Individual provider Licensed Practical Nurse · NPI 1912624115

Edjeanine Boucicault, LPN is a Licensed Practical Nurse in Lake Ronkonkoma, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2022
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

See every abbreviation used in this directory →

Practice location Address checks out

153 Lake Shore Rd
Lake Ronkonkoma, NY 11779-3193
Phone: (631) 522-6876
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 332414-1 (NY)

Record details

NPI number1912624115
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPN
Sole proprietorYes
NPI enumeratedOctober 27, 2022
Last updated in NPPESOctober 27, 2022
Certification dateOctober 27, 2022

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