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

Madison Antionette Boutureira

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1154889590

Madison Antionette Boutureira is a Student in an Organized Health Care Education/Training Program in Ithaca, New York. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2

Practice location Address checks out

953 Danby Rd
Ithaca, NY 14850-7000
Phone: (914) 874-6296
Show map & directions

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1154889590
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 5, 2019
Last updated in NPPESMarch 5, 2019

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