Paul Guglielmo

Individual provider Active NPI Registered Dietitian · Perrysburg, NY

NPI 1922323005 · NPPES record last updated Apr 1, 2010

Key facts

NPI
1922323005
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
000059-1 (NY)
Practice address
10714 North Rd
Perrysburg, NY 14129-9746
Phone
(716) 532-1049
Fax
(716) 532-0679
NPI assigned
Apr 1, 2010
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
000059-1NYMDRegistered Dietitian
000059NYMDCommunity Health Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000059-1 NY Yes

Addresses

Primary practice location

10714 North Rd
Perrysburg, NY 14129-9746

Mailing address

108 Carefree LN
Cheektowaga, NY 14227-2219
Phone (716) 668-5380

Other providers in Perrysburg, NY

All providers in Perrysburg, NY · Registered Dietitian in New York

Sources for this page

Verify at the official NPI Registry.