Provider Demographics
NPI:1205970217
Name:HEALTHGUARD INC
Entity type:Organization
Organization Name:HEALTHGUARD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-634-9384
Mailing Address - Street 1:217 BEACH 95TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11693-1303
Mailing Address - Country:US
Mailing Address - Phone:718-634-9384
Mailing Address - Fax:718-318-8866
Practice Address - Street 1:217 BEACH 95TH ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY BEACH
Practice Address - State:NY
Practice Address - Zip Code:11693-1303
Practice Address - Country:US
Practice Address - Phone:718-634-9384
Practice Address - Fax:718-318-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003258R173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02188618Medicaid
NY02188618Medicaid
NYX65127Medicare UPIN