Healthcare Provider Details
I. General information
NPI: 1437125952
Provider Name (Legal Business Name): JOSEPH GAFFNEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/24/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 PATERSON ST SUITE 6140
NEW BRUNSWICK NJ
08901-1962
US
IV. Provider business mailing address
66 WEST GILBERT ST
RED BANK NJ
07701
US
V. Phone/Fax
- Phone: 732-235-7905
- Fax: 212-544-1974
- Phone: 732-212-0051
- Fax: 732-212-0713
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 154328 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 25MA04975000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: