Provider Demographics
NPI:1114155637
Name:GUCCIONE, AMY L (DDS)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:GUCCIONE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:L
Other - Last Name:SHIH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:88 LAKE AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-3940
Mailing Address - Country:US
Mailing Address - Phone:347-724-4422
Mailing Address - Fax:
Practice Address - Street 1:30 POPHAM RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4134
Practice Address - Country:US
Practice Address - Phone:914-725-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051031-11223P0700X, 122300000X
NY0510311223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics