Provider Demographics
NPI:1437536943
Name:GUTERMAN, STEVEN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:GUTERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TANI
Other - Middle Name:
Other - Last Name:GUTERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1810 AVENUE N
Mailing Address - Street 2:APARTMENT 3D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6105
Mailing Address - Country:US
Mailing Address - Phone:917-664-3985
Mailing Address - Fax:
Practice Address - Street 1:1810 AVENUE N
Practice Address - Street 2:APARTMENT 3D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6105
Practice Address - Country:US
Practice Address - Phone:917-664-3985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019386225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist