Provider Demographics
NPI:1760630578
Name:GUINETTE, GORDON
Entity Type:Individual
Prefix:MR
First Name:GORDON
Middle Name:
Last Name:GUINETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:PA
Mailing Address - Zip Code:17517
Mailing Address - Country:US
Mailing Address - Phone:717-445-7169
Mailing Address - Fax:717-445-7169
Practice Address - Street 1:1366 CLEARVIEW DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:PA
Practice Address - Zip Code:17517
Practice Address - Country:US
Practice Address - Phone:717-445-7169
Practice Address - Fax:717-445-7169
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02859237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter