MEDICARE: ROLINE GUERRIER PA-C

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	363A00000X	Physician Assistant	006896-1	NY

General Provider Information

NPI Number	:	1215958640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLINE GUERRIER PA-C

Provider Business Mailing Address
First Line	:	544 7TH AVE
Second Line	:	ROOM 103
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6140
Country	:	US
Telephone Number	:	718-788-4482
Fax Number	:	718-768-0213

Provider Business Practice Location Address
First Line	:	544 7TH AVE
Second Line	:	ROOM 103
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6140
Country	:	US
Telephone Number	:	718-788-4482
Fax Number	:	718-768-0213

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/10/2021

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