Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 25MD00280900 | NJ |
N | 222Z00000X | Podiatrist | 25MD00280900 | NJ |
Y | 213E00000X | Podiatrist | N005957 | NY |
Y | 222Z00000X | Podiatrist | N005957 | NY |
NPI | 1043285331 |
---|---|
Provider Name | Dr. Heath Gutterman |
First Address | Plainview, NY 11803-3226 |
Second Address | East Meadow, NY 11554-2719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0043559 | (05) | NJ |
02560589 | (05) | NY |
U99850 | (02) | NY |