Healthcare Provider Details

I. General information

NPI: 1275532533
Provider Name (Legal Business Name): ADAM DEUTSCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 PARK AVE
NEW YORK NY
10028-0971
US

IV. Provider business mailing address

1036 PARK AVE STE 1A
NEW YORK NY
10028-0971
US

V. Phone/Fax

Practice location:
  • Phone: 212-879-9000
  • Fax: 212-535-3344
Mailing address:
  • Phone: 212-879-9000
  • Fax: 212-535-3344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number196704
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: