Active NPI
Carl Henri Boucicaut, REGISTERED NURSE
- Registered Nurse
- Huntington, NY
National Provider Identifier
1962279786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 897314-01
- Practice address
- 6 Stuyvesant St
Huntington, NY 11743-4719 - Phone
- (631) 455-3888
- NPI assigned
- Dec 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 897314-01 | NY | Primary |
Addresses
Primary practice location
6 Stuyvesant St
Huntington, NY 11743-4719
Mailing address
6 Stuyvesant St
Huntington, NY 11743-4719
Phone (631) 455-3888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 897314-01 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702252800000",
"number": "1962279786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 STUYVESANT ST",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434719",
"telephone_number": "631-455-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 STUYVESANT ST",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434719",
"telephone_number": "631-455-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCICAUT",
"first_name": "CARL",
"middle_name": "HENRI",
"credential": "REGISTERED NURSE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-11",
"last_updated": "2023-12-11",
"certification_date": "2023-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "897314-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.