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Individual

DR. MARK GURTOVY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7620 BAY PKWY STE 1-B, BROOKLYN, NY 11214-1516
(718) 232-1492
(718) 232-4505
Mailing address
7620 BAY PKWY STE 1-B, BROOKLYN, NY 11214-1516
(718) 232-1492
(718) 232-4505

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
200341
NY
2084P0800X
Psychiatry Physician
MA 67468
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01740601
NY
05
8364605
NJ
Enumeration date
07/23/2006
Last updated
07/19/2010
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