Healthcare Provider Details

I. General information

NPI: 1255818241
Provider Name (Legal Business Name): MRS. SHARI MICHELLE GUZZETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SHARI MICHELLE TRONTZ

II. Dates (important events)

Enumeration Date: 07/23/2018
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 RUSSELL ST
FRANKLIN SQUARE NY
11010-2516
US

IV. Provider business mailing address

1035 RUSSELL ST
FRANKLIN SQUARE NY
11010-2516
US

V. Phone/Fax

Practice location:
  • Phone: 516-993-6808
  • Fax:
Mailing address:
  • Phone: 516-993-6808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: