| Doctor Name: | MRS. RUSUDAN GUTMAN |
| NPI Number: | 1275871444 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 636435-1 |
| Business Practice Address: | 30 Mell Dr North Babylon, NY - 117033210 |
| Business Phone Number: | 6315868931 |
| Business Fax Number: | |
| Mailing Address: | 30 Mell Dr, NORTH BABYLON |
| State: | NY |
| Postal Code: | 117033210 |
| Phone Number: | 6313554392 |
| Fax Number: | |
| NPI Enumeration Date: | 01/23/2013 |
| NPI Last Update Date: | 01/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | 636435-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |