Provider Demographics
NPI:1326482670
Name:STEVEN GUTSIN DPM PC
Entity Type:Organization
Organization Name:STEVEN GUTSIN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GUTSIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:716-903-2407
Mailing Address - Street 1:PO BOX 1195
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-8195
Mailing Address - Country:US
Mailing Address - Phone:716-646-6006
Mailing Address - Fax:716-646-6996
Practice Address - Street 1:41 BENDER DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2330
Practice Address - Country:US
Practice Address - Phone:716-646-6006
Practice Address - Fax:716-646-6996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005177213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01537255Medicaid
NYBB4324Medicare UPIN