Provider Demographics
NPI:1578500294
Name:LOUTSCH, ERICA M (MD)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:M
Last Name:LOUTSCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:95 GRASSLANDS ROAD
Mailing Address - Street 2:NYMC BEHAVIORAL HEALTH CENTER ROOM N326
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-7124
Mailing Address - Fax:914-493-1015
Practice Address - Street 1:95 GRASSLANDS ROAD
Practice Address - Street 2:NYMC BEHAVIORAL HEALTH CENTER ROOM N326
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7124
Practice Address - Fax:914-493-1015
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0954992084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01238857Medicaid
NY01238857Medicaid
NY41A351Medicare PIN