Provider Demographics
NPI:1215647698
Name:FERDINAND, GUERLINE
Entity type:Individual
Prefix:
First Name:GUERLINE
Middle Name:
Last Name:FERDINAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23141 128TH RD
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-1310
Mailing Address - Country:US
Mailing Address - Phone:917-421-2270
Mailing Address - Fax:
Practice Address - Street 1:23141 128TH RD
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-1310
Practice Address - Country:US
Practice Address - Phone:917-421-2270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY309246-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse