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General NPI Number Information
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NPI Number | 1639103955
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Entity Type | Individual
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Provider Name | THOMAS GERARD GUGLIELMO D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 131 KENT RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-3485
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Country | US
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Telephone | 860-354-8616
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Fax | 860-354-0473
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Provider Business Mailing Address
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Address Line | 131 KENT RD
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City | NEW MILFORD
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State | CT
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Zip | 06776-3485
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Country | US
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Telephone | 860-354-8616
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Fax | 860-354-0473
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00676
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License Number State | CT
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