Provider Demographics
NPI:1073547048
Name:GUERNICA, ADELE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:MARIE
Last Name:GUERNICA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 2ND AVE
Mailing Address - Street 2:SUITE 750, BUILDING C
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-3600
Mailing Address - Country:US
Mailing Address - Phone:610-409-9440
Mailing Address - Fax:610-409-9164
Practice Address - Street 1:555 2ND AVE
Practice Address - Street 2:SUITE 750, BUILDING C
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3600
Practice Address - Country:US
Practice Address - Phone:610-409-9440
Practice Address - Fax:610-409-9164
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010605L207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology