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General NPI Number Information
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NPI Number | 1578536876
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Entity Type | Individual
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Provider Name | JOSEPH ANTHONY BIFANO MD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | HSC LEVEL 4 ROOM 120 STONY BROOK UNIVERSITY HOSPITAL -RADIOLOGY
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City | STONY BROOK
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State | NY
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Zip | 11794-8460
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Country | US
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Telephone | 631-444-7955
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Fax | 631-444-7538
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Provider Business Mailing Address
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Address Line | 1 GUTHRIE DR CORNING HOSPITAL -DEPT OF RADIOLOGY
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City | CORNING
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State | NY
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Zip | 14830-8460
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Country | US
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Telephone | 570-888-5858
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Fax | 607-937-7647
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD072317L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 192746-1
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License Number State | NY
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