Provider Demographics
NPI:1053335539
Name:GUTKIN, STEVEN J (DC CCSP)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:GUTKIN
Suffix:
Gender:M
Credentials:DC CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:254 B MOUNTAIN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840
Mailing Address - Country:US
Mailing Address - Phone:908-852-4321
Mailing Address - Fax:908-852-5564
Practice Address - Street 1:254 B MOUNTAIN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840
Practice Address - Country:US
Practice Address - Phone:908-852-4321
Practice Address - Fax:908-852-5564
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00474200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
300232OtherASHN
9539201OtherGHI
10657938OtherCAQH
867576M0DOtherEMPIRE MEDICARE
9264392001OtherCIGNA
0981933000OtherAMERIHEALTH HMO
X5B351OtherBEECHSTREET
01000348600OtherAMERICHOICE
5086081OtherFIRST HEALTH
5371154OtherAETNA
1141015OtherHORIZON NJ HEALTH
9264392001OtherCIGNA
X5B351OtherBEECHSTREET