Provider Demographics
NPI:1396734059
Name:GUIDONE, ALICIA RAMONA (DPM)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:RAMONA
Last Name:GUIDONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:101 HALF MILE RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-4101
Mailing Address - Country:US
Mailing Address - Phone:203-640-0385
Mailing Address - Fax:203-453-6916
Practice Address - Street 1:141 DURHAM RD
Practice Address - Street 2:#15
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2676
Practice Address - Country:US
Practice Address - Phone:203-640-0385
Practice Address - Fax:203-453-6916
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000694213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT480001011OtherST RAPHAEL FACULTY PHYSICIAN MEDICINE
CTU73734Medicare UPIN
CT480001011OtherST RAPHAEL FACULTY PHYSICIAN MEDICINE