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

Jean Marc R Boucicault

Individual provider Licensed Practical Nurse · NPI 1396053500

Jean Marc R Boucicault is a Licensed Practical Nurse in Queens Village, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010

Practice location Address checks out

21211 102nd Ave Apt C4
Queens Village, NY 11429-1106
Phone: (718) 468-8298
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 301439 (NY)

Record details

NPI number1396053500
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 22, 2010
Last updated in NPPESSeptember 22, 2010

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