Provider Demographics
NPI:1164804597
Name:GUELCE, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:GUELCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 MONACO AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4331
Mailing Address - Country:US
Mailing Address - Phone:917-921-9824
Mailing Address - Fax:516-775-1294
Practice Address - Street 1:1810 MONACO AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4331
Practice Address - Country:US
Practice Address - Phone:917-921-9824
Practice Address - Fax:516-775-1294
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337903-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily