Healthcare Provider Details

I. General information

NPI: 1508243379
Provider Name (Legal Business Name): JULIANA GUARENTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 11TH ST BLDG ROOM8220
PHILADELPHIA PA
19107-4824
US

IV. Provider business mailing address

834 CHESTNUT ST SUITE 400
PHILADELPHIA PA
19107-5127
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-7379
  • Fax:
Mailing address:
  • Phone: 215-955-1085
  • Fax: 215-955-5041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD476932
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: