Healthcare Provider Details

I. General information

NPI: 1649497843
Provider Name (Legal Business Name): JOSEPH J CIUFFO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 GRAND AVE
MASPETH NY
11378-1523
US

IV. Provider business mailing address

7301 GRAND AVE
MASPETH NY
11378-1523
US

V. Phone/Fax

Practice location:
  • Phone: 718-457-5900
  • Fax: 718-457-5931
Mailing address:
  • Phone: 718-457-5900
  • Fax: 718-457-5931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number155718
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: