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General NPI Number Information
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NPI Number | 1619153061
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Entity Type | Organization
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Legal Business Name | REYNALDO C GUERRA, MD PC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 108 E NORTHAMPTON ST
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City | BATH
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State | PA
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Zip | 18014-1643
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Country | US
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Telephone | 610-837-7335
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Fax | 610-837-1340
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Provider Business Mailing Address
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Address Line | 108 E NORTHAMPTON ST
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City | BATH
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State | PA
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Zip | 18014-1643
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Country | US
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Telephone | 610-837-7335
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Fax | 610-837-1340
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. TAMMI GARGUILO
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Credential |
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Telephone | 610-837-7335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD032333E
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License Number State | PA
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