Provider Demographics
NPI:1215967740
Name:GUTHRIE, DEBRA S (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E 39TH ST STE 1103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0116
Mailing Address - Country:US
Mailing Address - Phone:212-685-2600
Mailing Address - Fax:212-685-0002
Practice Address - Street 1:6 E 39TH ST STE 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0116
Practice Address - Country:US
Practice Address - Phone:212-685-2600
Practice Address - Fax:212-685-0002
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161944-1207WX0009X
NY161944207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1423129Medicaid
NY01423129Medicaid
A64822Medicare UPIN
NY01423129Medicaid