Healthcare Provider Details

I. General information

NPI: 1548380488
Provider Name (Legal Business Name): MANUEL ALEJANDRO GUERRERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 CANAL ST #700
NEW YORK NY
10013-9400
US

IV. Provider business mailing address

350 CANAL ST #700
NEW YORK NY
10013-9400
US

V. Phone/Fax

Practice location:
  • Phone: 718-618-4321
  • Fax: 718-307-6482
Mailing address:
  • Phone: 718-618-4321
  • Fax: 718-307-6482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number236692
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number236692
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO214315
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: