Provider Demographics
NPI:1538321617
Name:GUAGLIARDO, THOMAS STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STEVEN
Last Name:GUAGLIARDO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:825 TOWN CENTER DR
Mailing Address - Street 2:SUITE 152
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1753
Mailing Address - Country:US
Mailing Address - Phone:215-741-3510
Mailing Address - Fax:215-741-3519
Practice Address - Street 1:825 TOWN CENTER DR
Practice Address - Street 2:SUITE 152
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1753
Practice Address - Country:US
Practice Address - Phone:215-741-3510
Practice Address - Fax:215-741-3519
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS014643207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0323187Medicaid
PA1027257070003Medicaid
PAOS014643OtherSTATE LICENSE