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General NPI Number Information
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NPI Number | 1568491751
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Entity Type | Individual
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Provider Name | STEVEN GUARDA VIANA ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 W CURTIS ST
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City | LINDEN
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State | NJ
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Zip | 07036-5772
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Country | US
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Telephone | 908-963-8561
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Fax | 908-486-1630
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Provider Business Mailing Address
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Address Line | 2187 VAUXHALL RD
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City | UNION
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State | NJ
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Zip | 07083-5823
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Country | US
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Telephone | 908-964-7606
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Fax | 908-486-1630
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 25MT00113200
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License Number State | NJ
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