BERT WALTER GOTTESMAN M.D. NPI 1417234774

NPI Information

  • NPI: 1417234774
  • Provider Name: BERT WALTER GOTTESMAN, M.D.
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 4802 12TH AVE
    1B
    BROOKLYN, NY
    ZIP 11219
  • Phone: (347) 417-1165

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NPI Details

Bert Walter Gottesman, M.D. is a general practice in Brooklyn, NY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Bert Walter Gottesman, M.D. NPI is 1417234774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4802 12TH AVE
1B
BROOKLYN, NY
ZIP 11219-072
Phone: (347) 417-1165

The enumeration date for this NPI number is 11/14/2011 and was last updated on 1/28/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & Rehabilitation148220NEW YORKNo
2208D00000XGeneral Practice148220NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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