Nilsa Socorro Gutierrez, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

153405 Issued in NY

Practice address

1045 Glen Cove Ave
Roslyn, NY 11576-1206

Phone

(201) 679-2993

NPI assigned

May 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1922265446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 PENN AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076661611",
            "telephone_number": "201-928-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GLEN COVE AVE",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761206",
            "telephone_number": "201-679-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "NILSA",
        "middle_name": "SOCORRO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "153405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy-Ann Grenan, NP
• Avigail O Grossmann, P.T.
• Gisella Del Pilar Guichard, NP
• Gina M Guido
• Ronald J Gulotta, M.D.
• Elizabeth Guzzo, CRNA
• Farnaz Hadaghian
• Tammy Halkias, AG-NP
• Robin Hananel
• Harbor Family Dental LLP

• Internal Medicine Physician in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.