Individual
DR. JOSE MIGUEL LARES-GUIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 WADSWORTH AVE, NEW YORK, NY 10033-6102
(646) 682-7544
(646) 666-0339
Mailing address
111 WADSWORTH AVE, NEW YORK, NY 10033-6102
(646) 682-7544
(646) 666-0339
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
249492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03161662
—
NY
01
—
03161662-03
ADAP
NY
01
—
249492
MEDICAL LICENSE
NY
Enumeration date
05/07/2009
Last updated
11/06/2025
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