Provider Demographics
NPI:1497967624
Name:GUCCIONE, GLADYS MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:GLADYS
Middle Name:MARIA
Last Name:GUCCIONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PEREGRINE CT
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2148
Mailing Address - Country:US
Mailing Address - Phone:203-913-4054
Mailing Address - Fax:
Practice Address - Street 1:29 PEREGRINE CT
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2148
Practice Address - Country:US
Practice Address - Phone:203-913-4054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001119111N00000X
MD01802111N00000X
NYX007635-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050001119CT01OtherANTHEM BLUE CROSS BLUE SH
CTU56396Medicare UPIN