Provider Demographics
NPI:1548864481
Name:GUGINO, ANTHONY L
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:GUGINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HOLLYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2536
Mailing Address - Country:US
Mailing Address - Phone:585-590-9795
Mailing Address - Fax:
Practice Address - Street 1:220 HOLLYBROOK RD
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2536
Practice Address - Country:US
Practice Address - Phone:585-590-9795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer