MEDICARE: DR. NILS A. GUTTENPLAN M.D.

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
1	174400000X	Specialist	245033	NY

General Provider Information

NPI Number	:	1952399610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILS A. GUTTENPLAN M.D.

Provider Business Mailing Address
First Line	:	1421 3RD AVE
Second Line	:	5TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10028-1802
Country	:	US
Telephone Number	:	212-249-6500
Fax Number	:	212-249-2906

Provider Business Practice Location Address
First Line	:	1421 3RD AVE
Second Line	:	5TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10028-1802
Country	:	US
Telephone Number	:	212-249-6500
Fax Number	:	212-249-2906

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	12/21/2009

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