Provider Demographics
NPI:1013923747
Name:GUIDO, THOMAS WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WILLIAM
Last Name:GUIDO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:GUIDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:275 ROCKAWAY TPKE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1232
Mailing Address - Country:US
Mailing Address - Phone:516-371-2225
Mailing Address - Fax:516-371-3773
Practice Address - Street 1:275 ROCKAWAY TPKE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1232
Practice Address - Country:US
Practice Address - Phone:516-371-2225
Practice Address - Fax:516-371-3773
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor