Individual
KATRINA GUGLIELMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
433 LAKE AVE, SAINT JAMES, NY 11780-2207
(163) 158-4601
Mailing address
200 HOWELLS RD, BAY SHORE, NY 11706-5351
(631) 666-1956
(631) 666-1957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
005502
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005502
NYS MEDICAL LICENSE NUMBE
NY
Enumeration date
04/12/2007
Last updated
10/31/2023
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