Provider Demographics
NPI:1689946329
Name:GUARINO, JACQUELINE (RN)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:GUARINO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9102 COLONIAL RD
Mailing Address - Street 2:3B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6111
Mailing Address - Country:US
Mailing Address - Phone:718-238-1007
Mailing Address - Fax:
Practice Address - Street 1:9102 COLONIAL RD
Practice Address - Street 2:3B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6111
Practice Address - Country:US
Practice Address - Phone:718-238-1007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY527857163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse