Provider Demographics
NPI:1609863497
Name:GUIDONE, LISA C (MS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:GUIDONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:721 E GENESEE ST
Mailing Address - Street 2:FL 2
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1505
Mailing Address - Country:US
Mailing Address - Phone:315-476-3127
Mailing Address - Fax:315-476-3136
Practice Address - Street 1:721 E GENESEE ST
Practice Address - Street 2:FL 2
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1505
Practice Address - Country:US
Practice Address - Phone:315-476-3124
Practice Address - Fax:315-476-3124
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2013-04-10
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Provider Licenses
StateLicense IDTaxonomies
NY001329207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00561353Medicaid
NY00561353Medicaid