Organization Name: | SANDRA GUTIERREZ, MD LLC |
NPI Number: | 1609007178 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SANDRA M GUTIERREZ (PHYSICIAN) |
Mailing Address: | 86 New Brunswick Ave Hopelawn |
State: | NJ US |
Postal Code: | 088612242 |
Phone Number: | 7328261881 |
Fax Number: | 7328261108 |
NPI Enumeration Date: | 08/01/2009 |
NPI Last Update Date: | 08/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 25MA068014 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |