Provider Demographics
NPI:1093419913
Name:GUIDERA, JULIA (MSPED)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GUIDERA
Suffix:
Gender:F
Credentials:MSPED
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:JOHNSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPED
Mailing Address - Street 1:51 COUGHLAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-3149
Mailing Address - Country:US
Mailing Address - Phone:718-702-8069
Mailing Address - Fax:
Practice Address - Street 1:51 COUGHLAN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-3149
Practice Address - Country:US
Practice Address - Phone:718-702-8069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist