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NPI Code Detail

MEDICARE: DR. RENEE GUTMAN

MEDICARE:  DR. RENEE  GUTMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103G00000XClinical Neuropsychologist3678AZ
2103G00000XClinical Neuropsychologist011178-1NY

General Provider Information

NPI Number : 1134578677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEE GUTMAN
Provider Business Mailing Address
First Line : 5715 N CALLE DE LUCIMIENTO
Second Line :
City : TUCSON
State : AZ
Zip : 85718-5134
Country : US
Telephone Number : 520-299-1224
Fax Number : 520-299-2208
Provider Business Practice Location Address
First Line : 5715 N CALLE DE LUCIMIENTO
Second Line :
City : TUCSON
State : AZ
Zip : 85718-5134
Country : US
Telephone Number : 520-299-1224
Fax Number : 520-299-2208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2016
Last Update Date : 12/07/2025

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Directions to “ DR. RENEE GUTMAN ” Practice Location

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