Healthcare Provider Details

I. General information

NPI: 1598805442
Provider Name (Legal Business Name): CAROLINE MACLAINE GUZMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVE KOUNTZ PAVILLION 5TH FLOOR -
NEW YORK NY
10037
US

IV. Provider business mailing address

22 POST AVE APT 24
NEW YORK NY
10034-5735
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-3368
  • Fax: 212-939-3399
Mailing address:
  • Phone: 646-453-4333
  • Fax: 212-939-3399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: