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Individual

DR. DMITRY GUTKOVICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1850 VETERANS MEMORIAL HWY, ISLANDIA, NY 11362
(631) 851-1564
(631) 851-1688
Mailing address
1850 VETERANS MEMORIAL HWY, ISLANDIA, NY 11362
(631) 851-1564
(631) 851-1688

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005657
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01899581
NY
Enumeration date
05/31/2005
Last updated
01/07/2008
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