Provider Demographics
NPI:1306859467
Name:WINCH, GUY L (PHD)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:L
Last Name:WINCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 5TH AVE
Mailing Address - Street 2:SUITE 2205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8728
Mailing Address - Country:US
Mailing Address - Phone:212-679-7323
Mailing Address - Fax:
Practice Address - Street 1:245 5TH AVE
Practice Address - Street 2:SUITE 2205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:212-679-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011318-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV96481Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER