Healthcare Provider Details

I. General information

NPI: 1225552409
Provider Name (Legal Business Name): CINDY GUZMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2017
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N MAIN ST
FREEPORT NY
11520-2243
US

IV. Provider business mailing address

7222 153RD ST APT 3G
FLUSHING NY
11367-2642
US

V. Phone/Fax

Practice location:
  • Phone: 516-377-8014
  • Fax:
Mailing address:
  • Phone: 929-421-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF308158
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: