Provider Demographics
NPI:1487917803
Name:GUARENTE, GINA (OSC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:GUARENTE
Suffix:
Gender:F
Credentials:OSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 JEANNE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1701
Mailing Address - Country:US
Mailing Address - Phone:845-256-0330
Mailing Address - Fax:845-566-3421
Practice Address - Street 1:34 JEANNE DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1701
Practice Address - Country:US
Practice Address - Phone:845-256-0330
Practice Address - Fax:845-566-3421
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator