MEDICARE: ZHANNA V. GUTNIK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	207278	NY

General Provider Information

NPI Number	:	1417929167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZHANNA V. GUTNIK MD

Provider Business Mailing Address
First Line	:	1616 VOORHIES AVE
Second Line	:	SUITE A
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3914
Country	:	US
Telephone Number	:	718-332-5678
Fax Number	:	718-332-7739

Provider Business Practice Location Address
First Line	:	1616 VOORHIES AVE
Second Line	:	SUITE A
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3914
Country	:	US
Telephone Number	:	718-332-5678
Fax Number	:	718-332-7739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	09/16/2015

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