Provider Demographics
NPI:1598045924
Name:GUTMAJER, ANDREW JUSTIN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JUSTIN
Last Name:GUTMAJER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 ARBUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598
Mailing Address - Country:US
Mailing Address - Phone:516-778-9488
Mailing Address - Fax:
Practice Address - Street 1:610 ARBUCKLE AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598
Practice Address - Country:US
Practice Address - Phone:917-267-9234
Practice Address - Fax:516-778-9489
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400056192Medicare PIN