Provider Demographics
NPI:1730471608
Name:GUGINO, FRANK A JR (RN)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:A
Last Name:GUGINO
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ALBERTA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1139
Mailing Address - Country:US
Mailing Address - Phone:716-832-0720
Mailing Address - Fax:716-832-5867
Practice Address - Street 1:575 ALBERTA DR
Practice Address - Street 2:SUITE 2
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1139
Practice Address - Country:US
Practice Address - Phone:716-832-0720
Practice Address - Fax:716-832-5867
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY476386163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00769324OtherOUT PATIENT MEDICAID PROVIDER #