Healthcare Provider Details

I. General information

NPI: 1891935581
Provider Name (Legal Business Name): SARA C CIOFFI CPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N COLEMAN RD
CENTEREACH NY
11720-3063
US

IV. Provider business mailing address

50 N COLEMAN RD
CENTEREACH NY
11720-3063
US

V. Phone/Fax

Practice location:
  • Phone: 631-698-1960
  • Fax:
Mailing address:
  • Phone: 631-698-1960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number0000546-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0000546-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: