Provider Demographics
NPI:1427872134
Name:GUAMAN, CLEBER ISRAEL
Entity type:Individual
Prefix:
First Name:CLEBER
Middle Name:ISRAEL
Last Name:GUAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FARREL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2407
Mailing Address - Country:US
Mailing Address - Phone:516-507-0410
Mailing Address - Fax:
Practice Address - Street 1:47 FARREL ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2407
Practice Address - Country:US
Practice Address - Phone:516-507-0410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant