Healthcare Provider Details

I. General information

NPI: 1952328775
Provider Name (Legal Business Name): VINCENT J GULFO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 ROUTE 94 S
WARWICK NY
10990-3658
US

IV. Provider business mailing address

PO BOX 1068
WARWICK NY
10990-8067
US

V. Phone/Fax

Practice location:
  • Phone: 845-987-7260
  • Fax: 845-988-5749
Mailing address:
  • Phone: 845-987-7260
  • Fax: 845-988-5749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number28567
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number28567
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number28567
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number28567
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number28567
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number28567
License Number StateNY
# 7
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number28567
License Number StateNY

VIII. Authorized Official

Name: VINCENT J GULFO
Title or Position: OWNER
Credential: MD
Phone: 845-987-7260