Provider Demographics
NPI:1093817744
Name:GUERRIERO, MARISA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:
Last Name:GUERRIERO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-1100
Mailing Address - Country:US
Mailing Address - Phone:718-886-3660
Mailing Address - Fax:718-886-3615
Practice Address - Street 1:2550 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1100
Practice Address - Country:US
Practice Address - Phone:718-886-3660
Practice Address - Fax:718-886-3615
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005080111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07494Medicare ID - Type Unspecified