Individual
CLYDE LACE DE GUZMAN GOROBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4312 56TH STREET, APT F1, WOODSIDE, NY 11377
(347) 829-3890
(347) 829-3888
Mailing address
4312 56TH STREET, APT 1F, WOODSIDE, NY 11377
(347) 829-3890
(347) 829-3888
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
054317
NY
Other
Enumeration date
06/23/2025
Last updated
12/04/2025
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