Provider Demographics
NPI:1992708713
Name:GUTSTEIN, ADINA S (MSN, CRNP)
Entity type:Individual
Prefix:MS
First Name:ADINA
Middle Name:S
Last Name:GUTSTEIN
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19446-7605
Mailing Address - Country:US
Mailing Address - Phone:267-613-8081
Mailing Address - Fax:
Practice Address - Street 1:818 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5104
Practice Address - Country:US
Practice Address - Phone:215-629-1158
Practice Address - Fax:215-825-5914
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP006745C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP45480Medicare UPIN
PA053190Medicare PIN