Provider Demographics
NPI:1558380816
Name:GRATCH, NOAH SOL (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:SOL
Last Name:GRATCH
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 1:820 2ND AVE
Mailing Address - Street 2:3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-661-3376
Mailing Address - Fax:212-661-6327
Practice Address - Street 1:820 2ND AVE
Practice Address - Street 2:3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4502
Practice Address - Country:US
Practice Address - Phone:212-661-3376
Practice Address - Fax:212-661-6327
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229531207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI45948Medicare UPIN
NY3K638WT411Medicare PIN
NY3K6381Medicare ID - Type Unspecified