Individual
KEVIN JORGE GUZMAN AGUILAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
3240 54TH ST FL 2, WOODSIDE, NY 11377-1928
(201) 355-7656
Mailing address
3240 54TH ST FL 2, WOODSIDE, NY 11377-1928
(201) 355-7656
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
18-412
NY
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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