Provider Demographics
NPI:1134140767
Name:GUARINO, RALPH VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:VICTOR
Last Name:GUARINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 STATE HIGHWAY 37 WEST
Mailing Address - Street 2:SUITE A DEER CHASE PROFESSIONAL PARK
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8056
Mailing Address - Country:US
Mailing Address - Phone:732-286-0440
Mailing Address - Fax:732-286-2885
Practice Address - Street 1:160 STATE HIGHWAY 37 WEST
Practice Address - Street 2:SUITE A DEER CHASE PROFESSIONAL PARK
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8056
Practice Address - Country:US
Practice Address - Phone:732-286-0440
Practice Address - Fax:732-286-2885
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04501400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1689207Medicaid
NJ034668CR1Medicare ID - Type Unspecified
NJ1689207Medicaid