Provider Demographics
NPI:1770586372
Name:GUGINO, LAWRENCE JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAMES
Last Name:GUGINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4154 MCKINLEY PKWY
Mailing Address - Street 2:STE 290 HAMBURG OB/GYN GROUP
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-2995
Mailing Address - Country:US
Mailing Address - Phone:716-649-6500
Mailing Address - Fax:716-649-0031
Practice Address - Street 1:4154 MCKINLEY PKWY
Practice Address - Street 2:STE 290, HAMBURG OB/GYN GROUP
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219
Practice Address - Country:US
Practice Address - Phone:716-649-6500
Practice Address - Fax:716-649-0031
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY174516-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10093701OtherUNIVERA
NY01182425Medicaid
NY005108786OtherCOMMUNITY BLUE
NY0710692OtherINDEPENDENT HEALTH
NY161019149OtherUNITED HEALTH CARE
NY161019149OtherNOVA
NY161019149OtherFIDELIS
NY161019149OtherAETNA
NY161019149OtherEMPIRE
NY405464OtherWELLCARE
NY161019149OtherFIDELIS
NYE41534Medicare UPIN