Guadarrama, Charise Yvonne

Guadarrama, Charise Yvonne is an individual health care provider with primary practice located at 93-19 Roosevelt Avenue , Jackson Heights NY 11372. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Guadarrama, Charise Yvonne can be contacted via phone (718) 803-8463.

Contact Information

Primary practice address
93-19 Roosevelt Avenue Jackson Heights NY 11372
Phone: (718) 803-8463
Fax: (718) 803-8465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 011162 New York

Profile Details

NPI number 1124046305
LBN Legal business name Guadarrama, Charise Yvonne
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Jun 4th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124046305 NPPES
New York MEDICAID 02850219

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