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General NPI Number Information
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NPI Number | 1982742565
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Entity Type | Individual
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Provider Name | ALAIN A. LE GUILLOU M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2039 PALMER AVE SUITE 203
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City | LARCHMONT
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State | NY
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Zip | 10538-2483
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Country | US
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Telephone | 914-834-1590
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Fax | 914-315-6225
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Provider Business Mailing Address
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Address Line | 2039 PALMER AVE SUITE 203
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City | LARCHMONT
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State | NY
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Zip | 10538-2483
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Country | US
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Telephone | 914-834-1590
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Fax | 914-315-6225
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 199443
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License Number State | NY
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