Individual
DR. FRITZ BOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
485 THROOP AVE, 3RD FLOOR, BROOKLYN, NY 11212
(718) 574-2462
Mailing address
PO BOX 74, 125 WORTH ST RM 901, NEW YORK, NY 10013-4006
(212) 442-8468
(212) 442-8452
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
132932
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105AH
GHI
NY
01
—
0105AI
GHI
NY
01
—
05A94
EMPIRE
NY
Enumeration date
08/31/2006
Last updated
07/08/2007
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