Provider Demographics
NPI:1629389937
Name:GUARIN, FERDINAND D (PT)
Entity Type:Individual
Prefix:MR
First Name:FERDINAND
Middle Name:D
Last Name:GUARIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8411 QUEENS BLVD
Mailing Address - Street 2:UNIT 3
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3098
Mailing Address - Country:US
Mailing Address - Phone:718-779-5588
Mailing Address - Fax:718-658-0306
Practice Address - Street 1:4540 CENTER BLVD APT 3009
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11109-5821
Practice Address - Country:US
Practice Address - Phone:718-779-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030254174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030254OtherPHYSICAL THERAPY LICENSE