Provider Demographics
NPI:1851616684
Name:DEUTCH, ANDREW SCOTT
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:SCOTT
Last Name:DEUTCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 39TH ST
Mailing Address - Street 2:7K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7200
Mailing Address - Country:US
Mailing Address - Phone:516-650-5172
Mailing Address - Fax:
Practice Address - Street 1:240 E 39TH ST
Practice Address - Street 2:7K
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-7200
Practice Address - Country:US
Practice Address - Phone:516-650-5172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist