Healthcare Provider Details

I. General information

NPI: 1902801103
Provider Name (Legal Business Name): LUDOVICO GUARINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 48TH ST
BROOKLYN NY
11219-2918
US

IV. Provider business mailing address

977 48TH ST
BROOKLYN NY
11219-2919
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-8260
  • Fax: 718-635-6147
Mailing address:
  • Phone: 718-283-6652
  • Fax: 718-635-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number144574
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: