Healthcare Provider Details

I. General information

NPI: 1043656358
Provider Name (Legal Business Name): MICHAEL STEVEN CIOFOLETTI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 WATERS PL
BRONX NY
10461-2700
US

IV. Provider business mailing address

6317 138TH ST
FLUSHING NY
11367-1121
US

V. Phone/Fax

Practice location:
  • Phone: 347-493-8569
  • Fax:
Mailing address:
  • Phone: 718-886-3920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number049436-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: