Provider Demographics
NPI:1083622096
Name:GUIRAND, CARLINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CARLINE
Middle Name:MARIE
Last Name:GUIRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 UTICA AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-629-3900
Mailing Address - Fax:718-629-6315
Practice Address - Street 1:1305 UTICA AVENUE
Practice Address - Street 2:UTICA AVENUE DIALYSIS
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-629-3900
Practice Address - Fax:718-629-6315
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182293207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01523431Medicaid
F79047Medicare UPIN
NY01523431Medicaid