Provider Demographics
NPI:1518973742
Name:GUERRERO, FIRPO EUGENIO (MD)
Entity Type:Individual
Prefix:MR
First Name:FIRPO
Middle Name:EUGENIO
Last Name:GUERRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1570
Mailing Address - Country:US
Mailing Address - Phone:973-589-5545
Mailing Address - Fax:973-589-0073
Practice Address - Street 1:275 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1570
Practice Address - Country:US
Practice Address - Phone:973-589-5545
Practice Address - Fax:973-589-0073
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04217500207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0391808Medicaid
NJC54562Medicare UPIN
NJ0391808Medicaid