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Individual

JEFFREY GUNZENHAUSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2444 86TH ST, BROOKLYN, NY 11214-4415
(570) 888-5858
Mailing address
PO BOX 32, NORTHBROOK, IL 60065-0032
(847) 593-8460
(847) 919-4615

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
184898
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
184898
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01673234
NY
01
GU039853
MEDICARE GROUP
PA
Enumeration date
08/26/2005
Last updated
10/22/2018
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