Provider Demographics
NPI:1962276998
Name:GUZMAN, ALICIA
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 HOE AVE
Mailing Address - Street 2:2A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-1680
Mailing Address - Country:US
Mailing Address - Phone:347-780-6338
Mailing Address - Fax:
Practice Address - Street 1:1290 HOE AVE
Practice Address - Street 2:2A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-1680
Practice Address - Country:US
Practice Address - Phone:347-780-6338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027731-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist