Healthcare Provider Details

I. General information

NPI: 1558948406
Provider Name (Legal Business Name): GIOVANNA JULIA PATAFIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S ORANGE AVE
NEWARK NJ
07103-2757
US

IV. Provider business mailing address

185 S ORANGE AVE
NEWARK NJ
07103-2757
US

V. Phone/Fax

Practice location:
  • Phone: 914-260-4005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MB12812000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: