Provider Demographics
NPI:1013973189
Name:YOUCHAH, JOAN R (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:R
Last Name:YOUCHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-493-7124
Mailing Address - Fax:914-493-1015
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:BEHAVIORAL HEALTH CENTER N312
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7124
Practice Address - Fax:914-493-1015
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1625022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00994394Medicaid
NY00994394Medicaid
NY04G091Medicare ID - Type Unspecified