Provider Demographics
NPI:1821008194
Name:GUZI, TONI R (NP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:R
Last Name:GUZI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:R
Other - Last Name:GUZI SACCAVINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:225 WOODSTREAM WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214
Mailing Address - Country:US
Mailing Address - Phone:917-842-4287
Mailing Address - Fax:
Practice Address - Street 1:1260 HIGHWAY 54 WEST, SUITE 101
Practice Address - Street 2:FAYETTE CARE CLINIC
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-719-4620
Practice Address - Fax:770-719-4622
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212085363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02637034Medicaid
NY02637034Medicaid
NY97V881Medicare ID - Type Unspecified