Individual
DR. GORDON H BALTUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 W 168TH ST FL 4, NEW YORK, NY 10032-3726
(212) 305-6092
(212) 305-2026
Mailing address
710 W 168TH ST FL 4, NEW YORK, NY 10032-3726
(212) 305-6092
(215) 829-6645
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
25MA08687700
NJ
207T00000X
Neurological Surgery Physician
Primary
312637
NY
207T00000X
Neurological Surgery Physician
G87701
CA
207T00000X
Neurological Surgery Physician
MD058514L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015989750001
—
PA
Enumeration date
06/20/2006
Last updated
06/03/2024
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