Healthcare Provider Details

I. General information

NPI: 1881743938
Provider Name (Legal Business Name): DEBORAH RACHEL DUITCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 03/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LURIA 10
JERUSALEM ISRAEL
93391
IL

IV. Provider business mailing address

LURIA 10
JERUSALEM ISRAEL
93391
IL

V. Phone/Fax

Practice location:
  • Phone: 617-487-4627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number051555
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number051555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: