Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 005496 | NY |
NPI | 1184761249 |
---|---|
Provider Name | Mr. Louis Peter Guerra |
First Address | New York, NY 10021-9509 |
Second Address | New York, NY 10021-9509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |