Individual
DR. JOSE MANUEL GUTIERREZ AMEZCUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-0000
Mailing address
520 2ND AVE APT 11A, NEW YORK, NY 10016-8620
(929) 218-6210
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
042.0018655
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13-3971298
—
NY
Enumeration date
07/02/2019
Last updated
07/09/2025
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