Provider Demographics
NPI:1487765889
Name:KUTCHER, WILLIAM LEE (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:KUTCHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:444 LAKEVILLE RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1165
Mailing Address - Country:US
Mailing Address - Phone:516-352-3300
Mailing Address - Fax:516-352-3390
Practice Address - Street 1:444 LAKEVILLE RD
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1165
Practice Address - Country:US
Practice Address - Phone:516-352-3300
Practice Address - Fax:516-352-3390
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY146129207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01050646Medicaid
NYC05269Medicare UPIN
NY01050646Medicaid