Healthcare Provider Details

I. General information

NPI: 1174060313
Provider Name (Legal Business Name): MICHELE CAFONE PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MADISON AVE
NEW YORK NY
10029-6508
US

IV. Provider business mailing address

29 SPENCER DR
MORRISTOWN NJ
07960-3539
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-8662
  • Fax:
Mailing address:
  • Phone: 973-652-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number646842
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number382684
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: