MEDICARE: MARIE GUOBADIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225400000X	Rehabilitation Practitioner	154018	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821016734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE GUOBADIA MD

Provider Business Mailing Address
First Line	:	PO BOX 365
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11553
Country	:	US
Telephone Number	:	631-219-4979
Fax Number	:	718-616-4056

Provider Business Practice Location Address
First Line	:	2601 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7745
Country	:	US
Telephone Number	:	716-616-4046
Fax Number	:	718-616-4056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	10/14/2010

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Directions to “ MARIE GUOBADIA MD” Practice Location

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