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General NPI Number Information
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NPI Number | 1447921267
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Entity Type | Individual
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Provider Name | GENESIS GUZMAN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 3250 WESTCHESTER AVE STE 202
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City | BRONX
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State | NY
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Zip | 10461-4580
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Country | US
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Telephone | 347-621-2184
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3016
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City | SOUTH HACKENSACK
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State | NJ
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Zip | 07606-1016
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Country | US
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Telephone | 201-488-6678
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Fax | 201-342-4346
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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 | 118551-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL06711600
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License Number State | NJ
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