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General NPI Number Information
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NPI Number | 1063459030
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Entity Type | Individual
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Provider Name | JULIETA A DEGUZMAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 12506 101ST AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1412
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Country | US
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Telephone | 718-849-2900
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Fax | 718-943-2631
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Provider Business Mailing Address
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Address Line | 1000 ZECKENDORF BLVD
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City | GARDEN CITY
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State | NY
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Zip | 11530-2133
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Country | US
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Telephone | 516-542-6880
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Fax | 516-542-5556
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 156490
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License Number State | NY
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