Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 045714-1 | NY |
NPI | 1124262118 |
---|---|
Provider Name | Dr. Steven H Jutkowitz |
First Address | New York, NY 10021-3552 |
Second Address | New York, NY 10021-3552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 05/08/2021 |