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Individual

DR. GARY KOUTCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
68 HARRIS BUSHVILLE RD, HARRIS, NY 12742
(845) 791-7828
Mailing address
68 HARRIS BUSHVILLE RD, HARRIS, NY 12742
(845) 791-7828

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
138528
NY
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
25MA07301100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00382178
NY
05
8747407
NJ
Enumeration date
11/07/2006
Last updated
05/18/2016
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