Healthcare Provider Details

I. General information

NPI: 1396667093
Provider Name (Legal Business Name): MR. JONATHAN KWAI GUERRERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 SOUTH AVE W
WESTFIELD NJ
07090-1543
US

IV. Provider business mailing address

981 US HIGHWAY 22 STE 100
BRIDGEWATER NJ
08807-2946
US

V. Phone/Fax

Practice location:
  • Phone: 908-437-8672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number40QB00432200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: