Individual
JACQUELINE GUTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
78 CROMWELL AVE, STATEN ISLAND, NY 10304-3912
(718) 987-9175
(718) 987-1322
Mailing address
24 DOROTHY ST, STATEN ISLAND, NY 10314
(917) 679-8787
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
287666
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2013
Last updated
03/17/2018
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