Provider Demographics
NPI:1275532533
Name:DEUTSCH, ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:DEUTSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 PARK AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0971
Mailing Address - Country:US
Mailing Address - Phone:212-879-9000
Mailing Address - Fax:212-535-3344
Practice Address - Street 1:1036 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0971
Practice Address - Country:US
Practice Address - Phone:212-879-9000
Practice Address - Fax:212-535-3344
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196704207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
G83385Medicare UPIN
012001M7AMedicare ID - Type Unspecified