Healthcare Provider Details

I. General information

NPI: 1316065378
Provider Name (Legal Business Name): MICHAEL GUTKIN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 E NORTHFIELD RD STE 202 SUITE 202
LIVINGSTON NJ
07039-4806
US

IV. Provider business mailing address

349 E NORTHFIELD RD STE 202 SUITE 202
LIVINGSTON NJ
07039-4806
US

V. Phone/Fax

Practice location:
  • Phone: 973-597-1107
  • Fax: 973-597-1407
Mailing address:
  • Phone: 973-597-1107
  • Fax: 973-597-1407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA06846000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA02035200
License Number StateNJ

VIII. Authorized Official

Name: DR. MICHAEL GUTKIN
Title or Position: OWNER
Credential: MD
Phone: 973-597-1107