Provider Demographics
NPI:1568344026
Name:GUCKIN, REA (LO)
Entity type:Individual
Prefix:
First Name:REA
Middle Name:
Last Name:GUCKIN
Suffix:
Gender:F
Credentials:LO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 GLEN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3835
Mailing Address - Country:US
Mailing Address - Phone:203-499-9099
Mailing Address - Fax:
Practice Address - Street 1:325 GLEN HILLS RD
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3835
Practice Address - Country:US
Practice Address - Phone:203-499-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician