Provider Demographics
NPI:1851551519
Name:GUGGENHEIM, ISADORA (FNP)
Entity Type:Individual
Prefix:DR
First Name:ISADORA
Middle Name:
Last Name:GUGGENHEIM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROCKLAND PLACE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:845-893-2608
Mailing Address - Fax:845-358-2963
Practice Address - Street 1:8 ROCKLAND PLACE
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960
Practice Address - Country:US
Practice Address - Phone:845-893-2608
Practice Address - Fax:845-358-2963
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0003032083P0500X
NYF342569-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine