Provider Demographics
NPI:1588905459
Name:JOANNE GUADARA, LLC
Entity type:Organization
Organization Name:JOANNE GUADARA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUADARA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-342-8266
Mailing Address - Street 1:835 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4812
Mailing Address - Country:US
Mailing Address - Phone:201-342-8266
Mailing Address - Fax:201-342-8788
Practice Address - Street 1:835 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4812
Practice Address - Country:US
Practice Address - Phone:201-342-8266
Practice Address - Fax:201-342-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00360900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty