Provider Demographics
NPI:1205964962
Name:GUILLET, ANDRE D (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:D
Last Name:GUILLET
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:166 MIRIAM PKWY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4429
Mailing Address - Country:US
Mailing Address - Phone:516-770-9763
Mailing Address - Fax:
Practice Address - Street 1:148 WILSON AVENUE
Practice Address - Street 2:COMPREHENSIVE HEALTH CARE & REHABILATION SERVICES, LLC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3149
Practice Address - Country:US
Practice Address - Phone:718-455-5500
Practice Address - Fax:718-455-8700
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005911213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist