Provider Demographics
NPI:1871729285
Name:GUZMAN, ALLAN REY RENDON (LPN)
Entity type:Individual
Prefix:MR
First Name:ALLAN REY
Middle Name:RENDON
Last Name:GUZMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 GLENROCK RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6623
Mailing Address - Country:US
Mailing Address - Phone:609-788-4082
Mailing Address - Fax:
Practice Address - Street 1:113 GLENROCK RD.
Practice Address - Street 2:
Practice Address - City:EGG HARBORTOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6623
Practice Address - Country:US
Practice Address - Phone:609-788-4082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2966995164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse