Provider Demographics
NPI:1942297486
Name:GUINDI, RAYMOND SAMIR (PA-C)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:SAMIR
Last Name:GUINDI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 SHINNECOCK DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9502
Mailing Address - Country:US
Mailing Address - Phone:732-896-4444
Mailing Address - Fax:
Practice Address - Street 1:741 NORTHFIELD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1174
Practice Address - Country:US
Practice Address - Phone:973-736-9980
Practice Address - Fax:973-736-9981
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMP00091900363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP82175Medicare UPIN
NJ080832T25Medicare ID - Type Unspecified