Provider Demographics
NPI:1568458032
Name:GUARNACCIA, GARY JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:JOSEPH
Last Name:GUARNACCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:251 E 33RD ST LBBY 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4804
Mailing Address - Country:US
Mailing Address - Phone:212-336-3827
Mailing Address - Fax:212-388-6454
Practice Address - Street 1:251 E 33RD ST LBBY 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4804
Practice Address - Country:US
Practice Address - Phone:212-336-3827
Practice Address - Fax:212-388-6454
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03604200208D00000X
NY124783207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY339541OtherBCBS
NY2206787OtherAETNA INS
NY00406542Medicaid
NY0097345OtherGHI
NY0097345OtherGHI
NYB88879Medicare UPIN