Provider Demographics
NPI:1174858104
Name:GUZMAN, PEDRO (MD)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:
Last Name:GUZMAN
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 1:141 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5580
Mailing Address - Country:US
Mailing Address - Phone:570-497-4419
Mailing Address - Fax:570-497-4420
Practice Address - Street 1:141 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5580
Practice Address - Country:US
Practice Address - Phone:570-497-4419
Practice Address - Fax:570-497-4420
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-255127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine