Michelle Anne Entoma Guanzon, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

028729 Issued in NY

Practice address

21 Mill St
Liberty, NY 12754-2010

Phone

(845) 292-8810

Fax

(845) 292-8832

NPI assigned

Nov 24, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Center for Discovery Inc

  • Rural Health Clinic/Center
  • Monticello, NY
  • NPI 1275624694
  Medicare reassignment NPD
• The Center for Discovery Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Rock Hill, NY
  • NPI 1669202610
  NPD

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1922253566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 MILL ST",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542010",
            "telephone_number": "845-292-8810",
            "fax_number": "845-292-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MILL ST",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "127542010",
            "telephone_number": "845-292-8810",
            "fax_number": "845-292-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUANZON",
        "first_name": "MICHELLE ANNE",
        "middle_name": "ENTOMA",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "028729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Adult Neighbors Inc (Arcadia Residence)
• John Joseph Green, L.C.S.W.
• Tyler Green
• Cheryl Ann Greene, PTA-PHYSICAL THERAPI
• David Greenfield, P.T.
• Rommel Guanzon
• Susan E Hahn, LMSW
• Jill Harmon, LCSW
• Heal Safe Inc (Heal Safe)
• Stephanie Heisler

• Specialist in Liberty, NY
• Providers in Liberty, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.