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NPI Code Detail

MEDICARE: DR. ALICIA RAMONA GUIDONE D.P.M.

MEDICARE: DR. ALICIA RAMONA GUIDONE D.P.M.
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
1213E00000XPodiatrist000694CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1480001011OTHERCTST RAPHAEL FACULTY PHYSICIAN MEDICINE

General Provider Information

NPI Number : 1396734059
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALICIA RAMONA GUIDONE D.P.M.
Provider Business Mailing Address
First Line : 101 HALF MILE RD
Second Line :
City : GUILFORD
State : CT
Zip : 06437-4101
Country : US
Telephone Number : 203-640-0385
Fax Number : 203-453-6916
Provider Business Practice Location Address
First Line : 141 DURHAM RD
Second Line : #15
City : MADISON
State : CT
Zip : 06443-2676
Country : US
Telephone Number : 203-640-0385
Fax Number : 203-453-6916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 05/31/2011

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