Organization Active NPI

Blair J. Guidera, PC

  • Pediatrics Physician
  • Jericho, NY
National Provider Identifier
1164746319
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BLAIR J. GUIDERA, PC
Practice address
55 Jericho Tpke
Jericho, NY 11753-1013
Phone
(516) 338-0505
Fax
(516) 338-4378
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Authorized official

Name
Dr. Blair Jessup Guidera, MD
Title
Owner
Phone
(516) 338-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

55 Jericho Tpke
Jericho, NY 11753-1013

Mailing address

305 E 40TH St
Apt 2L
New York, NY 10016-2189
Phone (516) 338-0505

National Provider Directory

National Provider Directory

Locations

55 Jericho Tpke
Jericho, NY 11753
Phone (516) 338-0505

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1164746319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 40TH ST",
            "address_2": "APT 2L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100162189",
            "telephone_number": "516-338-0505",
            "fax_number": "516-338-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 JERICHO TPKE",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117531013",
            "telephone_number": "516-338-0505",
            "fax_number": "516-338-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR J. GUIDERA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "GUIDERA",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "JESSUP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-338-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.