Provider Demographics
NPI:1568456580
Name:GUERRERO, ISABEL C (MD)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:C
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 MULE RD
Mailing Address - Street 2:SUITE B1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5035
Mailing Address - Country:US
Mailing Address - Phone:732-286-2565
Mailing Address - Fax:732-286-7669
Practice Address - Street 1:25 MULE RD
Practice Address - Street 2:SUITE B1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5035
Practice Address - Country:US
Practice Address - Phone:732-286-2565
Practice Address - Fax:732-286-7669
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA39476207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3192407Medicaid
C56490Medicare UPIN
NJ3192407Medicaid
NJC56490Medicare UPIN