| Richard A Guild Edd Llc | |
|
323 Godwin Ave Midland Park NJ 07432-1501 | |
| (201) 652-0571 | |
| (201) 652-9748 |
| Full Name | Richard A Guild Edd Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 323 Godwin Ave, Midland Park, New Jersey |
| Authorized Official Name and Position | Richard A Guild (MEMBER) |
| Authorized Official Contact | 2016520571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard A Guild Edd Llc 323 Godwin Ave Midland Park NJ 07432-1501 Ph: (201) 652-0571 | Richard A Guild Edd Llc 323 Godwin Ave Midland Park NJ 07432-1501 Ph: (201) 652-0571 |
| NPI Number | 1659412054 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6204939564 |
|---|---|
| Medicare Enrollment ID | O20070307000479 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659412054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2246 (New Jersey) | Primary |
| Provider Name | Richard A Guild |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063436855 PECOS PAC ID: 2961448923 Enrollment ID: I20050630000280 |
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