1982924254 NPI number — MARGARET M GUGLIUZZA NURSE PRACTITIONER

Table of content: MARGARET M GUGLIUZZA NURSE PRACTITIONER (NPI 1982924254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982924254 NPI number — MARGARET M GUGLIUZZA NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUGLIUZZA
Provider First Name:
MARGARET
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982924254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5530 SHERIDAN DR
Provider Second Line Business Mailing Address:
1B
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-3730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-636-1947
Provider Business Mailing Address Fax Number:
716-636-1369

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5530 SHERIDAN DR
Provider Second Line Business Practice Location Address:
1B
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-3730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-636-1947
Provider Business Practice Location Address Fax Number:
716-636-1369
Provider Enumeration Date:
06/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  F301261-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00056512002 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0002655801 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9511937 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1982924254 . This is a "NON PAR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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