Provider Demographics
NPI:1518552355
Name:GUADAMUZ, MONICA (PTA)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:GUADAMUZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ROSEHILL TER
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1720
Mailing Address - Country:US
Mailing Address - Phone:914-844-2465
Mailing Address - Fax:
Practice Address - Street 1:963 SCARSDALE RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-4852
Practice Address - Country:US
Practice Address - Phone:914-810-2237
Practice Address - Fax:914-472-0783
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01269601225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant