Healthcare Provider Details

I. General information

NPI: 1912269937
Provider Name (Legal Business Name): WILLIAM ANTHONY CIOFFERO JR. MSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 FENWORTH BLVD
FRANKLIN SQUARE NY
11010-3535
US

IV. Provider business mailing address

655 FENWORTH BLVD
FRANKLIN SQUARE NY
11010-3535
US

V. Phone/Fax

Practice location:
  • Phone: 917-238-2198
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: