Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 051031-1 | NY |
N | 1223P0700X | Prosthodontist | 051031 | NY |
N | 1223P0700X | Prosthodontist | 051031-1 | NY |
NPI | 1114155637 |
---|---|
Provider Name | Mrs. Amy L Guccione |
First Address | Tuckahoe, NY 10707-3940 |
Second Address | Scarsdale, NY 10583-4134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 30/01/2020 |