Healthcare Provider Details

I. General information

NPI: 1215956230
Provider Name (Legal Business Name): LUCY ANGHARAD HUTNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE PARK AVENUE 8TH FLOOR
NEW YORK NY
10016
US

IV. Provider business mailing address

ONE PARK AVENUE 8TH FLOOR
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 646-754-4833
  • Fax:
Mailing address:
  • Phone: 646-754-4833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License Number244401
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number226652
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: