Provider Demographics
NPI:1467597666
Name:GUERREIRO, LUIS A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:GUERREIRO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 PARK AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5300
Mailing Address - Country:US
Mailing Address - Phone:908-753-1800
Mailing Address - Fax:908-753-2620
Practice Address - Street 1:100 CHARLES EWING BLVD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628
Practice Address - Country:US
Practice Address - Phone:800-370-3651
Practice Address - Fax:877-515-7147
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100294300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist