Basic Information
Provider Information
NPI: 1831685627
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GUZMAN
FirstName: FELIPE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 FEDERAL ST # 200
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081031088
CountryCode: US
TelephoneNumber: 8563564924
FaxNumber:  
Practice Location
Address1: 1 COOPER PLZ
Address2:  
City: CAMDEN
State: NJ
PostalCode: 081031461
CountryCode: US
TelephoneNumber: 8563422425
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/05/2018
LastUpdateDate: 08/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N193400000X SINGLE SPECIALTY GROUPStudent, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000X25MA11061900NJY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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