Healthcare Provider Details

I. General information

NPI: 1588641849
Provider Name (Legal Business Name): FRANK SCAFURI III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2177 VICTORY BLVD
STATEN ISLAND NY
10314-6603
US

IV. Provider business mailing address

2177 VICTORY BLVD
STATEN ISLAND NY
10314-6603
US

V. Phone/Fax

Practice location:
  • Phone: 718-370-3730
  • Fax: 718-698-9412
Mailing address:
  • Phone: 718-370-3730
  • Fax: 718-698-9412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number223726
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number223726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: