Male or Other

Dr. Gene L. Boucher DC

Chiropractor in Fairfield, NJ(View on Map)

Full Name

Dr. Gene Louis Boucher DC

NPI Number

1184694788

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/25/2006

Specialties

(Taxonomies)

Code

111N00000X
246ZE0600X

Primary Taxonomy

Yes
No

Licenses

State

New Jersey

License Number

MC005511

Contact
Information

Purpose

Mailing
Location

Address

26 MILL ST
26 MILL ST

City

Fairfield
Fairfield

State

NJ
NJ

Postal Code

07004-3824
07004-3824

Country

US
US

Telephone Number

(973) 650-5225
(736) 505-2259

Identifiers

Identifier

5489614
37-1499484
37-1499484

Identifier State

NJ
NJ
NJ

Identifier Issuer

AETNA HMO/PPO
QUALCARE
HORIZON BC/BS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/03/2020

Provider Address

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