Healthcare Provider Details

I. General information

NPI: 1770325516
Provider Name (Legal Business Name): ADARLYN GUZMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 ROSE ANN LN
CHESTER NY
10918-4003
US

IV. Provider business mailing address

58 ROSE ANN LN
CHESTER NY
10918-4003
US

V. Phone/Fax

Practice location:
  • Phone: 347-364-3358
  • Fax:
Mailing address:
  • Phone: 347-364-3358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number795975
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR22643700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: