Healthcare Provider Details

I. General information

NPI: 1215068952
Provider Name (Legal Business Name): JOHN MICHAEL CIUFFO RPH, JD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 STILLWATER AVE
STAMFORD CT
06902-4839
US

IV. Provider business mailing address

46 BRIGHTSIDE DR
STAMFORD CT
06902-8108
US

V. Phone/Fax

Practice location:
  • Phone: 203-324-0251
  • Fax: 203-348-0093
Mailing address:
  • Phone: 203-388-8613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047052
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6688
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: