Provider Demographics
NPI:1215901350
Name:MOUCHA, REMUS (MD)
Entity type:Individual
Prefix:
First Name:REMUS
Middle Name:
Last Name:MOUCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EAST MAIN STREET
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-666-1254
Mailing Address - Fax:914-666-1931
Practice Address - Street 1:400 EAST MAIN STREET
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-1254
Practice Address - Fax:914-666-1931
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158743207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
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10070193OtherCDPHP PIN#
5C7515OtherHEALTHNET PIN #
A63195Medicare UPIN