Provider Demographics
NPI:1548636459
Name:DOETSCH, MICHELLE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DOETSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 GREENWICH ST
Mailing Address - Street 2:APT 348
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-6329
Mailing Address - Country:US
Mailing Address - Phone:303-601-3380
Mailing Address - Fax:
Practice Address - Street 1:666 GREENWICH ST
Practice Address - Street 2:APT 348
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-6329
Practice Address - Country:US
Practice Address - Phone:303-601-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist