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NPI Code Detail

MEDICARE: ALICIA R GUIDONE, DPM LLC

MEDICARE: ALICIA R GUIDONE, DPM LLC
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
1213ES0131XFoot Surgery Podiatrist000694CT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16682620001OTHERMEDICARE DMEPOS PTAN

General Provider Information

NPI Number : 1639462401
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALICIA R GUIDONE, DPM LLC
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 :
Provider Business Practice Location Address
First Line : 141 DURHAM RD
Second Line : UNIT #15
City : MADISON
State : CT
Zip : 06443-2676
Country : US
Telephone Number : 203-421-6239
Fax Number : 203-421-6243
Authorized Official
Title or Position : PODIATRIST
Name : DR. ALICIA RAMONA GUIDONE
Credential : DPM
Telephone Number : 203-640-0385
Provider Enumeration Date : 05/26/2011
Last Update Date : 12/01/2015

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