Provider Demographics
NPI:1235224239
Name:GUTSIN, STEVEN BRUCE (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRUCE
Last Name:GUTSIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BENDER DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2330
Mailing Address - Country:US
Mailing Address - Phone:716-646-6006
Mailing Address - Fax:
Practice Address - Street 1:41 BENDER DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2330
Practice Address - Country:US
Practice Address - Phone:716-646-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005177-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01537255Medicaid
NYU52551Medicare UPIN
NYAAOO198Medicare ID - Type Unspecified