Provider Demographics
NPI:1669691317
Name:CUTLER, JANIS L (MD)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:L
Last Name:CUTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:340 RIVERSIDE DRIVE
Mailing Address - Street 2:APT 20
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-666-9750
Mailing Address - Fax:
Practice Address - Street 1:156 WEST 86TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4029
Practice Address - Country:US
Practice Address - Phone:212-362-3261
Practice Address - Fax:212-543-5356
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1594692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY700911Medicare ID - Type Unspecified
C11978Medicare UPIN