Provider Demographics
NPI:1104359322
Name:GUERRERO, KERLY (MD)
Entity type:Individual
Prefix:
First Name:KERLY
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MAIN STREET
Mailing Address - Street 2:DEPT OF OB/GYN
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503
Mailing Address - Country:US
Mailing Address - Phone:973-754-2700
Mailing Address - Fax:
Practice Address - Street 1:11 GETTY AVENUE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12160000207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine