Healthcare Provider Details

I. General information

NPI: 1669844460
Provider Name (Legal Business Name): GUTHEALTH MEDICAL P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 ADELPHI ST
BROOKLYN NY
11205-4602
US

IV. Provider business mailing address

55 GREENE AVE STE 1A
BROOKLYN NY
11238-6432
US

V. Phone/Fax

Practice location:
  • Phone: 718-395-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: KIRAN K BHAT
Title or Position: MD
Credential:
Phone: 718-398-2121