Individual
DR. GUILLERMO GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3654
(732) 324-6031
(732) 324-4811
Mailing address
PO BOX 48270, NEWARK, NJ 07101-8470
(201) 818-9118
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA05749600
NJ
208D00000X
General Practice Physician
25MA05749600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2490711000
AMERIHEALTH ID#
NJ
01
—
271940
AMERIGROUP ID#
NJ
01
—
39302
UHP ID#
NJ
01
—
3K3773
HEALTHNET #
NJ
01
—
60012743
HORIZON NJ HEALTH#
NJ
01
—
8220018
GHI PPO
NJ
01
—
P00211038
RAILROAD MEDICARE#
NJ
Enumeration date
08/22/2005
Last updated
05/09/2008
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