Healthcare Provider Details
I. General information
NPI: 1891029575
Provider Name (Legal Business Name): FRANK SCAFURI III D.O.P,C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2009
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
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
- Phone: 718-370-3730
- Fax: 718-698-9412
- Phone: 718-370-3730
- Fax: 718-698-9412
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FRANK
SCAFURI
Title or Position: OWNER/PHYSICIAN
Credential: D.O
Phone: 718-370-3730