Healthcare Provider Details

I. General information

NPI: 1699866947
Provider Name (Legal Business Name): ROBERT G HUTCHEON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 W 12TH ST PEDIATRICS/GENETICS
NEW YORK NY
10011-8202
US

IV. Provider business mailing address

450 W 33RD ST PBS 12TH FLOOR
NEW YORK NY
10001-2603
US

V. Phone/Fax

Practice location:
  • Phone: 212-356-4474
  • Fax: 212-356-4608
Mailing address:
  • Phone: 212-356-4474
  • Fax: 212-356-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number140947
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: