Provider Demographics
NPI:1265832745
Name:GUEYE, AIDARA
Entity Type:Individual
Prefix:
First Name:AIDARA
Middle Name:
Last Name:GUEYE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 VAN KLEECK ST APT 7L
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4231
Mailing Address - Country:US
Mailing Address - Phone:718-639-9716
Mailing Address - Fax:
Practice Address - Street 1:150 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2298
Practice Address - Country:US
Practice Address - Phone:646-505-3604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274498-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse