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General NPI Number Information
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NPI Number | 1649605056
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Entity Type | Individual
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Provider Name | JASON GOUTIS MD
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Gender | Male
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 100 WOODS RD. WESTCHESTER MEDICAL CENTER
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City | VALHALLA
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State | NY
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Zip | 10595
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Country | US
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Telephone | 914-493-6616
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Fax | 914-493-5827
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Provider Business Mailing Address
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Address Line | 19 BRADHURST AVE SUITE 3100N
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City | HAWTHORNE
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State | NY
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Zip | 10532-2140
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Country | US
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Telephone | 914-909-9018
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Fax | 914-909-9028
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 286032
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 286032
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License Number State | NY
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