Provider Demographics
NPI:1366962342
Name:GUARDINO, NICHOLAS JOHN
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:JOHN
Last Name:GUARDINO
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 1:26 INDIGOT DR
Mailing Address - Street 2:
Mailing Address - City:SLATE HILL
Mailing Address - State:NY
Mailing Address - Zip Code:10973-4009
Mailing Address - Country:US
Mailing Address - Phone:845-741-6876
Mailing Address - Fax:
Practice Address - Street 1:26 INDIGOT DR
Practice Address - Street 2:
Practice Address - City:SLATE HILL
Practice Address - State:NY
Practice Address - Zip Code:10973-4009
Practice Address - Country:US
Practice Address - Phone:845-741-6876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist