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General NPI Number Information
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NPI Number | 1588659775
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Entity Type | Individual
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Provider Name | JENNY P GUO MD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 140 MEISNER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1236
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Country | US
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Telephone | 347-951-9393
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Fax | 718-989-3131
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Provider Business Mailing Address
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Address Line | 38 PEOPLES LINE RD
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City | SOMERSET
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State | NJ
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Zip | 08873-7366
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Country | US
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Telephone | 347-951-9393
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Fax | 718-989-3131
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 229535
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License Number State | NY
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