Provider Demographics
NPI:1467663518
Name:GUIDA, JOHN (LMT, LAC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GUIDA
Suffix:
Gender:M
Credentials:LMT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HILTON AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-5116
Mailing Address - Country:US
Mailing Address - Phone:516-458-9037
Mailing Address - Fax:
Practice Address - Street 1:3233 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4507
Practice Address - Country:US
Practice Address - Phone:516-458-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003811171100000X
NY013135225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty