Provider Demographics
NPI:1689094062
Name:GUZMAN, NEIDA
Entity Type:Individual
Prefix:
First Name:NEIDA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 UNDERHILL AVE # 7
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2925
Mailing Address - Country:US
Mailing Address - Phone:347-879-5375
Mailing Address - Fax:
Practice Address - Street 1:641 UNDERHILL AVE # 7
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2925
Practice Address - Country:US
Practice Address - Phone:347-879-5375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist