Individual
DR. EDWARD IRA JUTKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. P.C.
Contact information
Practice address
70 GLEN COVE RD, SUITE 105, ROSLYN HEIGHTS, NY 11577-1726
(516) 621-9393
(516) 621-9409
Mailing address
70 GLEN COVE RD, SUITE 105, ROSLYN HEIGHTS, NY 11577-1726
(516) 621-9393
(516) 621-9409
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
39601
NY
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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