Individual
DR. FREDERICK GUTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 RESEARCH WAY SUITE 200, NEW YORK SPINE AND BRAIN SURGERY, EAST SETAUKET, NY 11733-3487
(631) 444-1213
(631) 444-1535
Mailing address
NEW YORK SPINE AND BRAIN SURGERY, HSC T12 RM 080, STONY BROOK, NY 11794-8122
(631) 444-1213
(631) 444-1535
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
168176
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01563437
—
NY
01
—
17J49
EMPIRE BC.BS
NY
01
—
4517102
AETNA
NY
Enumeration date
06/28/2006
Last updated
06/16/2014
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