Healthcare Provider Details

I. General information

NPI: 1871163469
Provider Name (Legal Business Name): ANNIKA GUILIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CLIFTON SPRINGS PROFESSIONAL PARK
CLIFTON SPRINGS NY
14432-1041
US

IV. Provider business mailing address

210 CLIFTON SPRINGS PROFESSIONAL PARK
CLIFTON SPRINGS NY
14432-1041
US

V. Phone/Fax

Practice location:
  • Phone: 585-563-6060
  • Fax: 585-426-4031
Mailing address:
  • Phone: 585-563-6060
  • Fax: 585-426-4031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: