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General NPI Number Information
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NPI Number | 1366671380
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Entity Type | Individual
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Provider Name | GUSTAVO HENRIQUE BOFF MAEGAWA M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2009
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 3959 BROADWAY # CH-7N
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City | NEW YORK
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State | NY
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Zip | 10032-1559
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Country | US
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Telephone | 212-305-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 3959 BROADWAY, CH-7N - 718 (GENETICS) COLUMBIA UNIVERSITY MORGANSTANLEY CHILDREN'S HOSPITAL
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City | NEW YORK
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State | NY
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Zip | 10032-0296
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Country | US
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Telephone | 212-342-3647
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | D69890
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | ME125350
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number | D69890
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number | ME125350
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207SG0207X
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Taxonomy Name | Medical Biochemical Genetics
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License Number | 314126
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 207SG0202X
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Taxonomy Name | Clinical Biochemical Genetics Physician
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License Number | 314126
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License Number State | NY
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