Provider Demographics
NPI:1417050030
Name:GUIDERA-DIAMOND, CAROL ANN (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:GUIDERA-DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:GUIDERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:285 WEST END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-579-1200
Mailing Address - Fax:212-579-9205
Practice Address - Street 1:285 WEST END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-579-1200
Practice Address - Fax:212-579-9205
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160944207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
07F313Medicare ID - Type Unspecified
D91850Medicare UPIN