Provider Demographics
NPI:1922670223
Name:GUALDRON, ILIANNA MARIA
Entity type:Individual
Prefix:
First Name:ILIANNA
Middle Name:MARIA
Last Name:GUALDRON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ILIANNA
Other - Middle Name:
Other - Last Name:GUALDRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:210 MELLON PL
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7133
Practice Address - Country:US
Practice Address - Phone:908-737-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional