Provider Demographics
NPI:1043009038
Name:MASSACCESI, GUILLERMO ADRIAN (MD)
Entity type:Individual
Prefix:MR
First Name:GUILLERMO
Middle Name:ADRIAN
Last Name:MASSACCESI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-01 BROADWAY, ELMHURST
Mailing Address - Street 2:NYC HEALTH HOSPITALS/ELMHURST-PEDIATRIC DEPARTMENT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-334-2156
Mailing Address - Fax:
Practice Address - Street 1:79-01 BROADWAY, ELMHURST
Practice Address - Street 2:NYC HEALTH HOSPITALS/ELMHURST-PEDIATRIC DEPARTMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program