Provider Demographics
NPI:1003298597
Name:GUILDNET, INC.
Entity Type:Organization
Organization Name:GUILDNET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP - FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIVANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-769-6286
Mailing Address - Street 1:15 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6601
Mailing Address - Country:US
Mailing Address - Phone:212-769-6200
Mailing Address - Fax:
Practice Address - Street 1:15 W 65TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6601
Practice Address - Country:US
Practice Address - Phone:212-769-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY302R00000X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03863105Medicaid