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General NPI Number Information
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NPI Number | 1487776324
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Entity Type | Individual
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Provider Name | ANNUNZIATO GAROFALO OD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 09/05/2017
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Provider Practice Location Address
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Address Line | 8216 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-2337
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Country | US
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Telephone | 330-856-4089
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Fax | 330-425-1615
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Provider Business Mailing Address
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Address Line | 1512 WAYNESBORO DR
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City | HUDSON
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State | OH
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Zip | 44236-5333
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Country | US
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Telephone | 330-425-1615
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Fax | 330-425-1615
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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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 03225298
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5308 T2217
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License Number State | OH
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