Healthcare Provider Details

I. General information

NPI: 1073538211
Provider Name (Legal Business Name): HEATH GUTTERMAN, DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 ELMWOOD CT
PLAINVIEW NY
11803-3226
US

IV. Provider business mailing address

32 ELMWOOD CT
PLAINVIEW NY
11803-3226
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-7156
  • Fax: 516-785-7156
Mailing address:
  • Phone: 516-785-7156
  • Fax: 516-785-7156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005957
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. HEATH GUTTERMAN
Title or Position: PODIATRIST
Credential: DPM
Phone: 516-785-7156