Individual
DR. MARIE E DY-GUILLAUME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8708 JUSTICE AVE STE CS, ELMHURST, NY 11373-8715
(718) 779-9599
(718) 779-9579
Mailing address
8708 JUSTICE AVE STE CS, ELMHURST, NY 11373-8715
(718) 779-9599
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
201321
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01788994
—
NY
01
—
G400002156
MEDICARE PTAN
NY
Enumeration date
04/13/2006
Last updated
07/01/2010
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