Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 253858 | NY |
NPI | 1013942085 |
---|---|
Provider Name | Jason P Gutman |
First Address | Rochester, NY 14621-3001 |
Second Address | Rochester, NY 14621-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 15/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03187579 | (05) | NY |