Provider Demographics
NPI:1649298043
Name:GUZMAN, ROMULO DARIO (MD)
Entity type:Individual
Prefix:
First Name:ROMULO
Middle Name:DARIO
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2913
Practice Address - Country:US
Practice Address - Phone:914-734-8800
Practice Address - Fax:914-734-8808
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178684208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01852964Medicaid
NY4939395Medicare UPIN
NY2697847Medicare UPIN
NY000891617Medicare UPIN
NY126838Medicare UPIN
NY59383 EF.6/1/02Medicare UPIN
NYWP656Medicare UPIN
NYOD2196Medicare UPIN
NY01852964Medicaid