Bruce Deitchman, M.D., LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

149505 Issued in NY

Legal business name

BRUCE DEITCHMAN, M.D., LLC

Practice address

635 Madison Ave FL 3
New York, NY 10022-1009

Phone

(212) 753-6048

NPI assigned

Aug 19, 2010

Last updated

Aug 19, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce A Detichman, M.D.

Title

Owner

Phone

(212) 753-6048

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282176000000",
    "number": "1285940999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-753-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MADISON AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221009",
            "telephone_number": "212-753-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE DEITCHMAN, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A",
        "authorized_official_last_name": "DETICHMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-753-6048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "149505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seada Brucaj
• Debbie Marie Brucato-Duncan, ACNP-BC
• Christopher Brucato
• Gary Jr. Brucato, PHD
• Julia Brucato, SLP-CF / TSSLD
• Bruce E. Katz, MD, PC (Juva Skin & Laser Center)
• Bruce E. Katz, MD, PC (Juva Skin & Laser Center)
• Bruce E. Katz, MD, PC (Juva Skin and Laser Center)
• Bruce H Yaffe Services, LLC
• Bruce H. Yaffe Medical Services, PLLC

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.