Provider Demographics
NPI:1518112986
Name:GUTHINGER AND MADEB M.D.S., PC
Entity Type:Organization
Organization Name:GUTHINGER AND MADEB M.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MADEB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-343-4555
Mailing Address - Street 1:36 ELLICOTT ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3137
Mailing Address - Country:US
Mailing Address - Phone:585-343-4555
Mailing Address - Fax:585-344-0735
Practice Address - Street 1:36 ELLICOTT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3137
Practice Address - Country:US
Practice Address - Phone:585-343-4555
Practice Address - Fax:585-344-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100000119Medicare PIN