Provider Demographics
NPI:1962873851
Name:GUNTHER, PERRY (LP)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:
Last Name:GUNTHER
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WOOSTER ST
Mailing Address - Street 2:4FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3857
Mailing Address - Country:US
Mailing Address - Phone:917-608-2673
Mailing Address - Fax:
Practice Address - Street 1:121 WOOSTER ST
Practice Address - Street 2:4FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3857
Practice Address - Country:US
Practice Address - Phone:917-608-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000952102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst