Healthcare Provider Details

I. General information

NPI: 1245742402
Provider Name (Legal Business Name): SALINA ANNE GUZMAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2017
Last Update Date: 10/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 AVENUE OF THE AMERICAS
NEW YORK NY
10013-1510
US

IV. Provider business mailing address

121 AVENUE OF THE AMERICAS
NEW YORK NY
10013-1510
US

V. Phone/Fax

Practice location:
  • Phone: 212-941-9090
  • Fax: 212-966-1840
Mailing address:
  • Phone: 212-941-9090
  • Fax: 212-966-1840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102088
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: