- Practice location
- 19 Bradhurst Ave, Hawthorne, NY 10532-2139
- Phone
- 914-345-0162
- Fax
- 914-347-4401
- Last updated
- May 5, 2008
Carlo Ivan Gwardschaladse is a Physician Assistant based in Hawthorne, NY. Carlo Ivan Gwardschaladse practices in Hawthorne, NY and has the professional credentials of PA. The NPI Number for Carlo Ivan Gwardschaladse is 1386639441 and holds a License No. 005375 (NY). The current practice location address for Carlo Ivan Gwardschaladse is 19 Bradhurst Ave, Hawthorne, NY 10532-2139 and can be reached out via phone at 914-345-0162 and via fax at 914-347-4401.
Provider Profile Details
- NPI Number
- 1386639441
- Provider Name
- Carlo Ivan Gwardschaladse
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 19 Bradhurst Ave, Hawthorne, NY 10532-2139
- Phone Number
- 914-345-0162
- Fax Number
- 914-347-4401
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 15, 2005
- Last Update Date
- May 5, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 19 Bradhurst Ave
Hawthorne, NY 10532-2139 - City
- Hawthorne
- State
- New York
- Zip
- 10532-2139
- Phone Number
- 914-345-0162
- Fax Number
- 914-347-4401
Provider Business Mailing Address Details
- Address
- 95 Grasslands RD
Munger Pavilion
Valhalla, NY 10595-1652 - City
- Valhalla
- State
- NY
- Zip
- 10595-1652
- Phone Number
- 914-493-7621
- Fax Number
- 914-594-4359
License Information
- License Number
- 005375
- License State
- NY
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Carlo I Gwardschaladse, PA?
The NPI number of Carlo I Gwardschaladse, PA is 1386639441. It was assigned on September 15, 2005 and is currently active in the NPPES registry.
What is the specialty of Carlo I Gwardschaladse, PA?
Carlo I Gwardschaladse, PA is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NY under license number 005375.
Where does Carlo I Gwardschaladse, PA practice?
The practice location is 19 Bradhurst Ave, Hawthorne, NY 10532-2139. The office can be reached at 914-345-0162 (phone) or 914-347-4401 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1386639441 directly on the NPPES registry website.