Healthcare Provider Details

I. General information

NPI: 1376780551
Provider Name (Legal Business Name): HOWARD RAYMOND GUIA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2009
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST DEPARTMENT OF CARDIOTHORACIC SURGERY
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

506 6TH ST DEPARTMENT OF CARDIOTHORACIC SURGERY
BROOKLYN NY
11215-3609
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-7700
  • Fax: 718-780-6701
Mailing address:
  • Phone: 718-780-7700
  • Fax: 646-967-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334359
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: