Provider Demographics
NPI:1073538211
Name:HEATH GUTTERMAN, DPM PC
Entity Type:Organization
Organization Name:HEATH GUTTERMAN, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-785-7156
Mailing Address - Street 1:32 ELMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3226
Mailing Address - Country:US
Mailing Address - Phone:516-785-7156
Mailing Address - Fax:516-785-7156
Practice Address - Street 1:32 ELMWOOD CT
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3226
Practice Address - Country:US
Practice Address - Phone:516-785-7156
Practice Address - Fax:516-785-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005957213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5368040001Medicare NSC
NYWET571Medicare ID - Type UnspecifiedMEDICARE NUMBER FOR GROUP
NYDC7753Medicare PIN