| R Guillen Md Pc | |
|
800 Grand Concourse Frnt Office5 Bronx NY 10451-3003 | |
| (718) 401-2300 | |
| (718) 401-2322 |
| Full Name | R Guillen Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Grand Concourse Frnt Office5, Bronx, New York |
| Authorized Official Name and Position | Rafael Antonio Guillen (MEDICAL DOCTOR) |
| Authorized Official Contact | 7184012300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Guillen Md Pc 800 Grand Concourse Frnt Office5 Bronx NY 10451-3003 Ph: (718) 401-2300 | R Guillen Md Pc 800 Grand Concourse Frnt Office5 Bronx NY 10451-3003 Ph: (718) 401-2300 |
| NPI Number | 1467612499 |
|---|---|
| Provider Enumeration Date | 06/12/2008 |
| Last Update Date | 05/28/2020 |
| Medicare PECOS PAC ID | 4486726478 |
|---|---|
| Medicare Enrollment ID | O20080708000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467612499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 233234 (New York) | Primary |
| Provider Name | Rafael A Guillen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861430076 PECOS PAC ID: 6901851807 Enrollment ID: I20050314000683 |
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