Healthcare Provider Details

I. General information

NPI: 1790276657
Provider Name (Legal Business Name): CENTRAL PARK EAST MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 E 34TH ST
BROOKLYN NY
11210
US

IV. Provider business mailing address

1408 E 34TH ST
BROOKLYN NY
11210-5428
US

V. Phone/Fax

Practice location:
  • Phone: 212-254-4351
  • Fax:
Mailing address:
  • Phone: 212-254-4351
  • 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 Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AHARON GUTTERMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 212-254-4351