MEDICARE: DR. HOWARD NEAL GUTNICK PH.D.

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	231H00000X	Audiologist	2201000182	VA

General Provider Information

NPI Number	:	1437406030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD NEAL GUTNICK PH.D.

Provider Business Mailing Address
First Line	:	2405 CAPE ARBOR DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1537
Country	:	US
Telephone Number	:	757-496-3270
Fax Number	:	855-228-0372

Provider Business Practice Location Address
First Line	:	2405 CAPE ARBOR DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1537
Country	:	US
Telephone Number	:	757-496-3270
Fax Number	:	855-228-0372

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

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	08/14/2012

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