Provider Demographics
NPI:1982879193
Name:SCOTT GUTZMANN & KEITH GUTZMANN D.C.P.C.
Entity Type:Organization
Organization Name:SCOTT GUTZMANN & KEITH GUTZMANN D.C.P.C.
Other - Org Name:HOWARD BEACH COMPREHENSIVE HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:P
Authorized Official - Last Name:GUTZMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-848-4200
Mailing Address - Street 1:16201 96TH ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-4029
Mailing Address - Country:US
Mailing Address - Phone:718-848-4200
Mailing Address - Fax:718-848-4049
Practice Address - Street 1:16201 96TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-4029
Practice Address - Country:US
Practice Address - Phone:718-848-4200
Practice Address - Fax:718-848-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007016-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty