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General NPI Number Information
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NPI Number | 1639462401
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Entity Type | Organization
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Legal Business Name | ALICIA R GUIDONE, DPM LLC
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 141 DURHAM RD UNIT #15
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City | MADISON
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State | CT
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Zip | 06443-2676
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Country | US
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Telephone | 203-421-6239
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Fax | 203-421-6243
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Provider Business Mailing Address
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Address Line | 101 HALF MILE RD
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City | GUILFORD
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State | CT
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Zip | 06437-4101
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Country | US
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Telephone | 203-640-0385
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. ALICIA RAMONA GUIDONE
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Credential | DPM
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Telephone | 203-640-0385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 000694
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License Number State | CT
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