Healthcare Provider Details

I. General information

NPI: 1073519807
Provider Name (Legal Business Name): ROSALYN KUTCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DAVIS AVE AT E POST RD
WHITE PLAINS NY
10601-4615
US

IV. Provider business mailing address

244 WESTCHESTER AVE STE 103
WHITE PLAINS NY
10604-2900
US

V. Phone/Fax

Practice location:
  • Phone: 941-681-1260
  • Fax: 914-681-2906
Mailing address:
  • Phone: 800-501-6388
  • Fax: 914-872-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number109497-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: