Provider Demographics
NPI:1841320892
Name:GUERIN, PHILIP J JR (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:GUERIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 RYE RIDGE PLAZA
Mailing Address - Street 2:STE 228
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-2826
Mailing Address - Country:US
Mailing Address - Phone:914-253-9190
Mailing Address - Fax:914-253-9192
Practice Address - Street 1:14 RYE RIDGE PLAZA
Practice Address - Street 2:STE 228
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2826
Practice Address - Country:US
Practice Address - Phone:914-253-9190
Practice Address - Fax:914-253-9192
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1035882084P0800X
CT0122432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY538371Medicare ID - Type Unspecified
C11085Medicare UPIN