Individual
NICOLE GUJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E MAIN ST, TRAUMA/ACS OFFICE, BAY SHORE, NY 11706-8408
(631) 968-7000
Mailing address
38705 ROUTE 25, PECONIC, NY 11958-1515
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
020689
NY
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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