| Doctor Name: | DR. FRITZ BOUTIN |
| NPI Number: | 1326150475 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 132932 |
| Business Practice Address: | 485 Throop Ave 3rd Floor Brooklyn, NY - 11212 |
| Business Phone Number: | 7185742462 |
| Business Fax Number: | |
| Mailing Address: | Po Box 74, 125 Worth St Rm 901 NEW YORK |
| State: | NY |
| Postal Code: | 100134006 |
| Phone Number: | 2124428468 |
| Fax Number: | 2124428452 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 132932 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |