Provider Demographics
NPI:1992763551
Name:GUERRIERO, GARY P (PT)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:P
Last Name:GUERRIERO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 MADISON AVE
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5403
Mailing Address - Country:US
Mailing Address - Phone:212-355-8440
Mailing Address - Fax:212-355-8439
Practice Address - Street 1:515 MADISON AVE
Practice Address - Street 2:FLOOR 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5403
Practice Address - Country:US
Practice Address - Phone:212-355-8440
Practice Address - Fax:212-355-8439
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008080-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY22-3580299OtherTAX ID
NYQ62062Medicare PIN
NYQ62062Medicare ID - Type Unspecified