Healthcare Provider Details

I. General information

NPI: 1144587445
Provider Name (Legal Business Name): MR. JAMES GUADINO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86-35 QUEENS BLVD SUITE 2LM
ELMHURST NY
11373
US

IV. Provider business mailing address

9 MARY LANE
ROSLYN HARBOR NY
11548
US

V. Phone/Fax

Practice location:
  • Phone: 516-413-2037
  • Fax: 516-723-9467
Mailing address:
  • Phone: 516-413-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471V0106X
TaxonomyVascular-Interventional Technology Radiologic Technologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code2471C1101X
TaxonomyCardiovascular-Interventional Technology Radiologic Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: