Provider Demographics
NPI:1710187190
Name:ANTHONY J GUARRACIN, D.O. LLC
Entity type:Organization
Organization Name:ANTHONY J GUARRACIN, D.O. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUARRACINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-960-3451
Mailing Address - Street 1:5771 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2274
Mailing Address - Country:US
Mailing Address - Phone:717-350-3514
Mailing Address - Fax:
Practice Address - Street 1:366 ALEXANDER SPRING ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9129
Practice Address - Country:US
Practice Address - Phone:717-249-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 007155 L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center