Individual
MS. AMY DAWN GUAGLIARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA,LPN
Contact information
Practice address
1527 KENYON RD, ONTARIO, NY 14519-8880
(716) 392-8504
Mailing address
469 W UNION ST, N/A, NEWARK, NY 14513-1316
(585) 683-7775
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
324571-1
NY
171W00000X
Contractor
002069-1
NY
Other
Enumeration date
02/02/2012
Last updated
03/29/2016
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