Individual
DOMINIC GUIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3754
(631) 920-8300
Mailing address
69 N SIDE RD, WADING RIVER, NY 11792-1112
(631) 953-3099
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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