Provider Demographics
NPI:1386838548
Name:GARY GUARNACCIA MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:GARY GUARNACCIA MEDICAL ASSOCIATES PC
Other - Org Name:MANHATTAN MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GUARNACCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-268-8383
Mailing Address - Street 1:251 E 33RD ST LBBY 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4804
Mailing Address - Country:US
Mailing Address - Phone:212-336-3827
Mailing Address - Fax:212-388-6454
Practice Address - Street 1:251 E 33RD ST LBBY 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4804
Practice Address - Country:US
Practice Address - Phone:212-336-3827
Practice Address - Fax:212-388-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124783207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00406542Medicaid
NY97345Medicare PIN
NY00406542Medicaid