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Contact Information

MARK W GUELZOW, MD
4101 MEDICAL CENTER DR STE 1C
FAYETTEVILLE, NY13066-6600
 Phone: 315-637-7878
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MARK W GUELZOW · (Male)

NPI Number 1124477484
Status Active
Credentials MD
Entity Individual
Enumeration date 06/08/2016
Last updated 07/03/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 301689
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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