Provider Demographics
NPI:1336224765
Name:GUARINO, SUSAN M (CHIROPRACTOR DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:GUARINO
Suffix:
Gender:F
Credentials:CHIROPRACTOR DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:858 JORALEMON STREET
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109
Mailing Address - Country:US
Mailing Address - Phone:973-759-3600
Mailing Address - Fax:973-759-3100
Practice Address - Street 1:858 JORALEMON STREET
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109
Practice Address - Country:US
Practice Address - Phone:973-759-3600
Practice Address - Fax:973-759-3100
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ1645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ459765ZBERMedicare PIN