MEDICARE: CARLINE MARIE GUIRAND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	182293	NY
2	207RN0300X	Nephrology Physician	182293	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083622096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLINE MARIE GUIRAND MD

Provider Business Mailing Address
First Line	:	1305 UTICA AVENUE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203
Country	:	US
Telephone Number	:	718-629-3900
Fax Number	:	718-629-6315

Provider Business Practice Location Address
First Line	:	1305 UTICA AVENUE
Second Line	:	UTICA AVENUE DIALYSIS
City	:	BROOKLYN
State	:	NY
Zip	:	11203
Country	:	US
Telephone Number	:	718-629-3900
Fax Number	:	718-629-6315

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	11/12/2010

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