Provider Demographics
NPI:1487055596
Name:GUZMAN, ROSA E (ND)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:E
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 14TH ST
Mailing Address - Street 2:APT. 6
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3163
Mailing Address - Country:US
Mailing Address - Phone:551-556-8473
Mailing Address - Fax:
Practice Address - Street 1:500 14TH ST
Practice Address - Street 2:APT. 6
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3163
Practice Address - Country:US
Practice Address - Phone:551-556-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJND100183174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist