Healthcare Provider Details

I. General information

NPI: 1508965344
Provider Name (Legal Business Name): RALPH JOHN CIFALDI JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 LAFAYETTE AVE
HAWTHORNE NJ
07506-2522
US

IV. Provider business mailing address

484 LAFAYETTE AVE
HAWTHORNE NJ
07506-2522
US

V. Phone/Fax

Practice location:
  • Phone: 973-423-4770
  • Fax: 973-423-4816
Mailing address:
  • Phone: 973-423-4770
  • Fax: 973-423-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMB059663
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMB059663
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: