Provider Demographics
NPI:1548380488
Name:GUERRERO, MANUEL ALEJANDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ALEJANDRO
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 1:350 CANAL ST
Mailing Address - Street 2:#700
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-9400
Mailing Address - Country:US
Mailing Address - Phone:718-618-4321
Mailing Address - Fax:718-307-6482
Practice Address - Street 1:350 CANAL ST
Practice Address - Street 2:#700
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-9400
Practice Address - Country:US
Practice Address - Phone:718-618-4321
Practice Address - Fax:718-307-6482
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2366922086S0127X, 208D00000X
ORDO214315208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA744SOtherGEISINGER HEALTH PLAN
PA744SOtherGEISINGER HEALTH PLAN