Healthcare Provider Details

I. General information

NPI: 1972368264
Provider Name (Legal Business Name): KAROLINA GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WATER ST
NEW YORK NY
10041-0004
US

IV. Provider business mailing address

55 WATER ST
NEW YORK NY
10041-0004
US

V. Phone/Fax

Practice location:
  • Phone: 212-815-1269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number120720-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: