Provider Demographics
NPI:1295746667
Name:GUARDINO, JOSEPH J II (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:GUARDINO
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:PROHEALTH PHYSICIANS
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5200
Mailing Address - Fax:860-284-5333
Practice Address - Street 1:945 MAIN ST
Practice Address - Street 2:SUITE 308
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-6064
Practice Address - Country:US
Practice Address - Phone:860-646-1900
Practice Address - Fax:860-645-3441
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT026583207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD32585Medicare UPIN