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Lynn Marie Guadagno

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as LYNN GUADAGNO.

Based on the most recent information from CMS, provider Lynn Marie Guadagno is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1083630958
Provider Type
Individual
Full Name
Guadagno, Lynn Marie
Title
Mrs.
Credential
PA

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/14/2006
Last Updated
9/24/2020

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-2839

Unlisted Fax

Mailing Location

9 Infield Ln, Matawan, NJ 07747-1702

(917) 991-0381

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 007049-1 New York
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 25MP00111600 New Jersey

Lynn Marie Guadagno

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Sirisena, Shalini

Pallas, Shirly

Lanter, Amanda

Weitzner, Esther

Shellock, Megan

Cho, Eunice

Salickram, Ravi R

Boss, Evelyn

Morales, Laisha Abigail

Otterbeck, Victoria Angela