MEDICARE: DR. GARY CHRISTOPHER GUERRINO M.D.

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	207R00000X	Internal Medicine Physician	181694-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	134045112	OTHER	NY	FEDERAL TAX I.D. #

General Provider Information

NPI Number	:	1811981194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY CHRISTOPHER GUERRINO M.D.

Provider Business Mailing Address
First Line	:	400 E SANDFORD BLVD
Second Line	:	SUITE B
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4725
Country	:	US
Telephone Number	:	914-699-0109
Fax Number	:	914-699-0385

Provider Business Practice Location Address
First Line	:	400 E SANDFORD BLVD
Second Line	:	SUITE B
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4725
Country	:	US
Telephone Number	:	914-699-0109
Fax Number	:	914-699-0385

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	12/16/2022

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