Healthcare Provider Details

I. General information

NPI: 1467429035
Provider Name (Legal Business Name): SUMATI B DEUTSCHER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 E MAIN ST
NEW ROCHELLE NY
10801-5711
US

IV. Provider business mailing address

177 E MAIN ST
NEW ROCHELLE NY
10801-5711
US

V. Phone/Fax

Practice location:
  • Phone: 914-355-4775
  • Fax:
Mailing address:
  • Phone: 914-355-4775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberTUV006466
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: