Provider Demographics
NPI:1346366754
Name:GUIDICE, ALBERT (LPN)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:GUIDICE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 41ST ST
Mailing Address - Street 2:5E
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3349
Mailing Address - Country:US
Mailing Address - Phone:917-306-8947
Mailing Address - Fax:
Practice Address - Street 1:4308 41ST ST
Practice Address - Street 2:5E
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-3349
Practice Address - Country:US
Practice Address - Phone:917-306-8947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274725164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse