Healthcare Provider Details

I. General information

NPI: 1477644953
Provider Name (Legal Business Name): MARTIN L. KUTSCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WESTCHESTER AVE STE N641
RYE BROOK NY
10573-1354
US

IV. Provider business mailing address

800 WESTCHESTER AVE STE N641
RYE BROOK NY
10573-1354
US

V. Phone/Fax

Practice location:
  • Phone: 914-232-1810
  • Fax: 914-455-4727
Mailing address:
  • Phone: 914-232-1810
  • Fax: 914-455-4727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number165778
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: