Provider Demographics
NPI:1699974733
Name:GUTTMAN, ALICIA (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:GUTTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:GUTTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:200 RIVERSIDE BLVD
Mailing Address - Street 2:APT 32-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069
Mailing Address - Country:US
Mailing Address - Phone:212-877-3134
Mailing Address - Fax:212-877-0627
Practice Address - Street 1:200 RIVERSIDE BLVD
Practice Address - Street 2:APT 32-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10069
Practice Address - Country:US
Practice Address - Phone:212-877-3134
Practice Address - Fax:212-877-0627
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139977102L00000X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry