Active NPI
Mark Gutkin, L.AC
- Acupuncturist
- Stamford, CT
National Provider Identifier
1629240320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 0393
- Practice address
- 111 High Ridge Rd 2ND Level
Stamford, CT 06905-3811 - Phone
- (203) 533-9463
- NPI assigned
- Apr 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 003404 | NY | |
| Acupuncturist | 171100000X | 393 | CT | |
| Acupuncturist | 171100000X | 0393 | CT | Primary |
Addresses
Primary practice location
111 High Ridge Rd 2ND Level
Stamford, CT 06905-3811
Mailing address
111 High Ridge Rd
2ND Level
Stamford, CT 06905-2300
Phone (203) 533-9463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0393 | CT | MD | Acupuncturist |
| 003404 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1629240320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HIGH RIDGE RD",
"address_2": "2ND LEVEL",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069052300",
"telephone_number": "203-533-9463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 HIGH RIDGE RD 2ND LEVEL",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069053811",
"telephone_number": "203-533-9463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTKIN",
"first_name": "MARK",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-02",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NY",
"license": "003404",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CT",
"license": "393",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CT",
"license": "0393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.