Provider Demographics
NPI:1437805603
Name:GUZMAN, ROBIN EUGENIO
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:EUGENIO
Last Name:GUZMAN
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 1:538 E FORDHAM RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-5015
Mailing Address - Country:US
Mailing Address - Phone:347-630-2323
Mailing Address - Fax:718-295-2404
Practice Address - Street 1:538 E FORDHAM RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5015
Practice Address - Country:US
Practice Address - Phone:347-630-2323
Practice Address - Fax:718-295-2404
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20-166246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist