Individual
BRENT GOTTESMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(718) 830-4200
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(718) 830-4200
(718) 830-1284
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
252236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000552202
ANTHEM
OH
Enumeration date
05/25/2007
Last updated
02/16/2016
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