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General NPI Number Information
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NPI Number | 1538252226
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Entity Type | Individual
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Provider Name | GREGORIO J. GUILLEN M.D
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 400 STATE ST. SUITE 2
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City | PERTH AMBOY
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State | NJ
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Zip | 08861
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Country | US
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Telephone | 732-442-6020
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Fax | 732-442-1995
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Provider Business Mailing Address
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Address Line | PO BOX 1608
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City | PERTH AMBOY
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State | NJ
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Zip | 08862-1608
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Country | US
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Telephone | 732-442-6020
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Fax | 732-442-1995
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MA56159
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License Number State | NJ
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