Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 25MA10874600 | NJ |
NPI | 1285052662 |
---|---|
Provider Name | Marla Guzman |
First Address | Berkeley Heights, NJ 07922-2104 |
Second Address | New Providence, NJ 07974-1218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 15/10/2020 |