Healthcare Provider Details

I. General information

NPI: 1043285331
Provider Name (Legal Business Name): HEATH GUTTERMAN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 W MONTAUK HWY STE 3
HAMPTON BAYS NY
11946-3551
US

IV. Provider business mailing address

32 ELMWOOD CT
PLAINVIEW NY
11803-3226
US

V. Phone/Fax

Practice location:
  • Phone: 631-287-1818
  • Fax:
Mailing address:
  • Phone: 516-785-7156
  • Fax: 516-465-0328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00280900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005957
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: