Healthcare Provider Details

I. General information

NPI: 1265622138
Provider Name (Legal Business Name): GEORGE ROFAIEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 06/20/2023
Certification Date: 06/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 S CEDAR CREST BLVD STE 210
ALLENTOWN PA
18103-6271
US

IV. Provider business mailing address

1250 S CEDAR CREST BLVD
ALLENTOWN PA
18103-6224
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8506
  • Fax: 610-402-1682
Mailing address:
  • Phone: 610-402-8506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number10521685-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberP1688
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number57.008375
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD480234
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: