Provider Demographics
NPI:1578860391
Name:GUAMAN, CELIA YOLANDA (COTA)
Entity Type:Individual
Prefix:
First Name:CELIA
Middle Name:YOLANDA
Last Name:GUAMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 79TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3057
Mailing Address - Country:US
Mailing Address - Phone:646-515-3322
Mailing Address - Fax:
Practice Address - Street 1:4242 79TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3057
Practice Address - Country:US
Practice Address - Phone:646-515-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007471-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant