Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 1683301 | NY |
Y | 111NI0900X | Internist | 1683301 | NY |
N | 207RG0300X | Geriatric Medicine | 1683301 | NY |
NPI | 1144288143 |
---|---|
Provider Name | Dr. Charles V Guida |
First Address | Southampton, NY 11969-2340 |
Second Address | Southampton, NY 11968-5087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 28/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00982861 | (05) | NY |
B58722 | (02) |