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General NPI Number Information
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NPI Number | 1942963640
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Entity Type | Individual
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Provider Name | RICHARD MICHAEL GUERTIN REGISTERED NURSE
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Gender | Male
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 100 N LAKE DR APT #45
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City | ORCHARD PARK
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State | NY
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Zip | 14127
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Country | US
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Telephone | 716-397-7146
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Fax | 585-380-9026
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Provider Business Mailing Address
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Address Line | 60 SCHOOL ST UNIT 1167
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City | ORCHARD PARK
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State | NY
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Zip | 14127-7051
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Country | US
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Telephone | 716-397-7146
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Fax |
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 365930-1
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License Number State | NY
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