Healthcare Provider Details

I. General information

NPI: 1023060076
Provider Name (Legal Business Name): PAUL TAFONE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KENYON AVE
WAKEFIELD RI
02879-4216
US

IV. Provider business mailing address

275 MARTINE ST SUITE 301
FALL RIVER MA
02723-1516
US

V. Phone/Fax

Practice location:
  • Phone: 508-675-7535
  • Fax: 508-675-7905
Mailing address:
  • Phone: 508-675-7535
  • Fax: 508-675-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberMD07757
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD07757
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: