Virginia de Guzman MD Limited Liability Company

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

041083 Issued in NJ

Legal business name

VIRGINIA DE GUZMAN MD LIMITED LIABILITY COMPANY

Practice address

688 Wyckoff Ave
Mahwah, NJ 07430-3033

Phone

(201) 891-3080

NPI assigned

Sep 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Virginia De Guzman, MD

Title

Owner

Phone

(201) 891-3080

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1013103183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303033",
            "telephone_number": "201-891-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303033",
            "telephone_number": "201-891-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA DE GUZMAN MD LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "DE GUZMAN",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-891-3080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "041083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.