Provider Demographics
NPI:1174358063
Name:REY VALZACCHI, GUIDO MARTIN
Entity type:Individual
Prefix:
First Name:GUIDO
Middle Name:MARTIN
Last Name:REY VALZACCHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 63RD ST APT 25L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7931
Mailing Address - Country:US
Mailing Address - Phone:646-897-8759
Mailing Address - Fax:
Practice Address - Street 1:504 E 63RD ST APT 25L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7931
Practice Address - Country:US
Practice Address - Phone:646-897-8759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program