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General NPI Number Information
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NPI Number | 1043110737
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Entity Type | Individual
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Provider Name | MATT GUERRA LMSW
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Gender | Male
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 3000 MARCUS AVE STE 3E01
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1006
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Country | US
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Telephone | 888-255-7040
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Fax |
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Provider Business Mailing Address
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Address Line | 15 PLYMOUTH RD
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City | BAYVILLE
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State | NY
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Zip | 11709-1924
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Country | US
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Telephone | 516-661-3856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 132638
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License Number State | NY
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