Provider Demographics
NPI:1659412054
Name:RICHARD A GUILD EDD LLC
Entity Type:Organization
Organization Name:RICHARD A GUILD EDD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUILD
Authorized Official - Suffix:
Authorized Official - Credentials:ED D
Authorized Official - Phone:201-652-0571
Mailing Address - Street 1:323 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1501
Mailing Address - Country:US
Mailing Address - Phone:201-652-0571
Mailing Address - Fax:201-652-9748
Practice Address - Street 1:323 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1501
Practice Address - Country:US
Practice Address - Phone:201-652-0571
Practice Address - Fax:201-652-9748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2246261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ475550Medicare ID - Type Unspecified