Teresa Ann Bouchard, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

X002932-1 Issued in NY

Practice address

371 Nassau Blvd
Garden City Park, NY 11040-5254

Phone

(516) 248-3647

Fax

(516) 414-8519

NPI assigned

Jun 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487682548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 NASSAU BLVD",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110405254",
            "telephone_number": "516-248-3647",
            "fax_number": "516-414-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 NASSAU BLVD",
            "city": "GARDEN CITY PARK",
            "state": "NY",
            "postal_code": "110405254",
            "telephone_number": "516-248-3647",
            "fax_number": "516-414-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X002932-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0079064",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0878669",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6687175",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "X4495",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Millet Alexander, RD
• Jennifer Dadnick Allsopp, FNP
• Unique Boyd
• Maria Brailsford
• Donna M. Braun, MA, CCC-SLP
• John L. Burzotta, DPM
• Tracey Lynne Cardello, LCSW

• Chiropractor in Garden City Park, NY
• Providers in Garden City Park, NY by specialty
• Chiropractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.