Provider Demographics
NPI:1881756708
Name:GUERRERO, MARILYN PEREGRINO (MD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:PEREGRINO
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15 WARREN ST
Mailing Address - Street 2:UNIT 110
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-6456
Mailing Address - Country:US
Mailing Address - Phone:202-432-7511
Mailing Address - Fax:718-579-4958
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:ROOM 420
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5360
Practice Address - Fax:718-579-4958
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY153404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist