MEDICARE: JAMES REED BOOTH MD

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	126915	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457438681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES REED BOOTH MD

Provider Business Mailing Address
First Line	:	337 N MAIN ST
Second Line	:	SUITE 2
City	:	NEW CITY
State	:	NY
Zip	:	10956-4310
Country	:	US
Telephone Number	:	845-634-9349
Fax Number	:	845-639-3031

Provider Business Practice Location Address
First Line	:	337 N MAIN ST
Second Line	:	SUITE 2
City	:	NEW CITY
State	:	NY
Zip	:	10956-4310
Country	:	US
Telephone Number	:	845-634-9349
Fax Number	:	845-639-3031

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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Directions to “ JAMES REED BOOTH MD” Practice Location

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