Provider Demographics
NPI:1710315643
Name:GUZZO, RIAN
Entity Type:Individual
Prefix:
First Name:RIAN
Middle Name:
Last Name:GUZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RIAN
Other - Middle Name:
Other - Last Name:BUNTZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2511
Mailing Address - Country:US
Mailing Address - Phone:347-497-1408
Mailing Address - Fax:
Practice Address - Street 1:41 SHELDON DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-4122
Practice Address - Country:US
Practice Address - Phone:845-513-5342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2022-12-05
Deactivation Date:2015-04-21
Deactivation Code:
Reactivation Date:2022-11-29
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator