Provider Demographics
NPI:1932277688
Name:GUAGENTI TAX, ELENA MARIE (DSW LCSWR)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:MARIE
Last Name:GUAGENTI TAX
Suffix:
Gender:F
Credentials:DSW LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 TOPLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:914-948-3251
Mailing Address - Fax:914-948-7691
Practice Address - Street 1:67 TOPLAND ROAD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-948-3251
Practice Address - Fax:914-948-7691
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0220561104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
206329OtherMANAGED HEALTH NETWORK
NYNC0261Medicare ID - Type Unspecified