Provider Demographics
NPI:1639382732
Name:ST. GEORGE, GUIDA MARIA (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:GUIDA
Middle Name:MARIA
Last Name:ST. GEORGE
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3331
Mailing Address - Country:US
Mailing Address - Phone:908-851-2770
Mailing Address - Fax:908-851-9023
Practice Address - Street 1:1308 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3331
Practice Address - Country:US
Practice Address - Phone:908-851-2770
Practice Address - Fax:908-851-9023
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00089200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant