Basic Information
| Provider Information | |||||||||
| NPI: | 1568853539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUISHARD | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| NameSuffix: | I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 PITNEY RD | ||||||||
| Address2: | |||||||||
| City: | ABSECON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082019716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096465400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1020 PITNEY RD | ||||||||
| Address2: | |||||||||
| City: | ABSECON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082019716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096465400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2015 | ||||||||
| LastUpdateDate: | 02/12/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XP0019X | 46TR00191300 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No ID Information.