Basic Information
| Provider Information | |||||||||
| NPI: | 1750380572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUARRACINI | ||||||||
| FirstName: | MARY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9W ROUTE | ||||||||
| Address2: | |||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864062 | ||||||||
| FaxNumber: | 8457864526 | ||||||||
| Practice Location | |||||||||
| Address1: | 51 N ROUTE 9W | ||||||||
| Address2: | |||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109931127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2005 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 163039 | NY | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.