Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | N005314 | NY |
NPI | 1053317024 |
---|---|
Provider Name | Dr. Lisamarie Guidice |
First Address | Rockaway Park, NY 11694-2861 |
Second Address | Rockaway Park, NY 11694 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 30/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U65777 | (02) | NY |