Gwardschaladse, Carlo Ivan

Gwardschaladse, Carlo Ivan is an individual health care provider with primary practice located at 19 Bradhurst Ave , Hawthorne NY 10532-2139. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gwardschaladse, Carlo Ivan can be contacted via phone (914) 345-0162.

Contact Information

Primary practice address
19 Bradhurst Ave Hawthorne NY 10532-2139
Phone: (914) 345-0162
Fax: (914) 347-4401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005375 New York

Profile Details

NPI number 1386639441
LBN Legal business name Gwardschaladse, Carlo Ivan
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated May 5th, 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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