Provider Demographics
NPI:1225413362
Name:GUERCIO, JESSICA M (BA, MA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:M
Last Name:GUERCIO
Suffix:
Gender:F
Credentials:BA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MARLBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-1615
Mailing Address - Country:US
Mailing Address - Phone:631-897-8132
Mailing Address - Fax:
Practice Address - Street 1:17 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-1615
Practice Address - Country:US
Practice Address - Phone:631-897-8132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist