Provider Demographics
NPI:1467038679
Name:GUARINO, CARMEN WILLIAM (OTR/L)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:WILLIAM
Last Name:GUARINO
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MAIN ST APT 212
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2965
Mailing Address - Country:US
Mailing Address - Phone:908-304-4773
Mailing Address - Fax:
Practice Address - Street 1:1211 HAMBURG TPKE # 224A
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5043
Practice Address - Country:US
Practice Address - Phone:973-800-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00970600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist