Organization
CROWN NEUROLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN GLENN GUTERMAN M.D. (M.D./OWNER)
(917) 902-8169
Entity
Organization
Contact information
Practice address
1181 WOODROW RD, STATEN ISLAND, NY 10309-1723
(917) 902-8169
Mailing address
405 19TH ST S, BRIGANTINE, NJ 08203-2027
(917) 902-8169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
266135-1
NY
2084N0400X
Neurology Physician
266135-1
NY
2084V0102X
Vascular Neurology Physician
Primary
266135-1
NY
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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