Healthcare Provider Details

I. General information

NPI: 1174588446
Provider Name (Legal Business Name): ALFRED A GAROFALO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 MADISON ST 5TH FLOOR 567
NEW YORK NY
10002-7537
US

IV. Provider business mailing address

132 EVERGREEN AVE
STATEN ISLAND NY
10305-1334
US

V. Phone/Fax

Practice location:
  • Phone: 212-238-7593
  • Fax: 212-238-7046
Mailing address:
  • Phone: 212-238-7593
  • Fax: 212-238-7046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005045
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: