Healthcare Provider Details

I. General information

NPI: 1639598188
Provider Name (Legal Business Name): DAVID J CIUFO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2014
Last Update Date: 04/28/2023
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 LAC DE VILLE BLVD BLDG D
ROCHESTER NY
14618-5647
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 665
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5321
  • Fax: 585-756-4721
Mailing address:
  • Phone: 585-719-7096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number304839
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: