Provider Demographics
NPI:1023143336
Name:DAVID, CAROLINA GUZMAN (MD)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:GUZMAN
Last Name:DAVID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 YORK AVENUE
Mailing Address - Street 2:APT 7D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3906
Mailing Address - Country:US
Mailing Address - Phone:212-988-4800
Mailing Address - Fax:
Practice Address - Street 1:133 EAST 73RD STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3556
Practice Address - Country:US
Practice Address - Phone:212-988-4800
Practice Address - Fax:212-472-6883
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60115055207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY569861Medicare ID - Type Unspecified
B77822Medicare UPIN