Rusudan Gutman, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

636435-1 Issued in NY

Practice address

30 Mell Dr
North Babylon, NY 11703-3210

Phone

(631) 586-8931

NPI assigned

Jan 23, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Rusudan Berishvili Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1275871444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MELL DR",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033210",
            "telephone_number": "631-355-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MELL DR",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033210",
            "telephone_number": "631-586-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "RUSUDAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "636435-1",
            "primary": true
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NY",
            "license": "636435-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUSUDAN",
            "last_name": "BERISHVILI",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol Gray
• Ronald Greenberg, MD
• Michael Grieco
• Anna Maria Caterina Gunther, PNP
• Patricia Guter
• Paula Haber, RN
• Joanne W. Hackert, PHD,CCC
• Gina Marie Haggerty
• Katelyn Anna Haggerty
• Karyn M Halpern, DMD

• Registered Nurse in North Babylon, NY
• Providers in North Babylon, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.