Provider Demographics
NPI:1801816483
Name:GUTWEIN, ANDREW (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:GUTWEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 GRASSLANDS RD-NYMC
Mailing Address - Street 2:DEPT OF MEDICINE-MUNGER PAVILION
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595
Mailing Address - Country:US
Mailing Address - Phone:914-493-8370
Mailing Address - Fax:914-594-4434
Practice Address - Street 1:95 GRASSLANDS RD-NYMC
Practice Address - Street 2:DEPT OF MEDICINE-MUNGER PAVILION
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-8370
Practice Address - Fax:914-594-4434
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137900OtherFIRST HEALTHPLAN
NY2590433OtherGHI PPO
NY696850OtherMVP
NYP2654006OtherOXFORD
NY00000071004OtherGHI HMO
NY2942700OtherAETNA HMO
NY02300301Medicaid
NY5C5576OtherHEALTHNET
GA5478OtherATLANTIS
NY7432388OtherAETNA PPO
NY110244075OtherRAILROAD MEDICARE
NY535371OtherEMPIRE BCBS
GA5478OtherATLANTIS