MEDICARE: ERIN JUNE GUIDA MS, ATC, NREMT

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	2255A2300X	Athletic Trainer		CO
2	2255A2300X	Athletic Trainer	003608-1	NY

General Provider Information

NPI Number	:	1114487592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN JUNE GUIDA MS, ATC, NREMT

Provider Business Mailing Address
First Line	:	149 MAIN ST
Second Line	:
City	:	HIGHLAND FALLS
State	:	NY
Zip	:	10928-1515
Country	:	US
Telephone Number	:	908-399-3613
Fax Number	:

Provider Business Practice Location Address
First Line	:	A-2530 TAYLOR STREET
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-1510
Country	:	US
Telephone Number	:	908-399-3613
Fax Number	:

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

Provider Enumeration Date	:	03/22/2019
Last Update Date	:	09/01/2022

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