Organization
JOSE LARES-GUIA PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE M LARES-GUIA MD (SOLE PROPRIETOR)
(917) 613-6030
Entity
Organization
Contact information
Practice address
84 GROVE ST APT 3, NEW YORK, NY 10014-3566
(646) 429-5555
(678) 553-1274
Mailing address
84 GROVE ST APT 3, NEW YORK, NY 10014-3566
(646) 429-9555
(646) 429-9555
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03161662
—
NY
Enumeration date
08/30/2013
Last updated
03/16/2024
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