MEDICARE: DR. BRUCE D LEUCHTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	225544	NY

General Provider Information

NPI Number	:	1174587166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE D LEUCHTER M.D.

Provider Business Mailing Address
First Line	:	1300 YORK AVE
Second Line	:	DEPARTMENT OF PSYCHIATRY
City	:	NEW YORK
State	:	NY
Zip	:	10065-4805
Country	:	US
Telephone Number	:	212-746-3427
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 YORK AVE
Second Line	:	DEPARTMENT OF PSYCHIATRY
City	:	NEW YORK
State	:	NY
Zip	:	10065-4805
Country	:	US
Telephone Number	:	212-746-3427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	01/03/2016

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