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Individual

LUIS MIGUEL GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
318 KNICKERBOCKER AVE, BROOKLYN, NY 11237-3888
(718) 765-6056
(347) 803-1874
Mailing address
PO BOX 746087, ATLANTA, GA 30374-6087
(312) 733-9730

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
311655
NY
363LG0600X
Gerontology Nurse Practitioner
26NJ14990800
NJ

Other

Enumeration date
01/23/2024
Last updated
05/14/2024
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