MEDICARE: J GUZMAN NURSE PRACTITIONER IN FAMILY HEALTH PC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1467160127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J GUZMAN NURSE PRACTITIONER IN FAMILY HEALTH PC

Provider Business Mailing Address
First Line	:	671 BRONX RIVER RD APT 4A
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10704-1728
Country	:	US
Telephone Number	:	646-591-3388
Fax Number	:

Provider Business Practice Location Address
First Line	:	577 W 161ST ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-6146
Country	:	US
Telephone Number	:	646-717-7741
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEANNETTE GUZMAN
Credential	:	FNP-BC
Telephone Number	:	646-591-3388

Provider Enumeration Date	:	11/11/2022
Last Update Date	:	11/11/2022

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