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General NPI Number Information
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NPI Number | 1639276447
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Entity Type | Individual
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Provider Name | DAVID R. PFAFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 420 LYNDALE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6131
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Country | US
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Telephone | 718-667-6776
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Fax | 718-667-5461
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Provider Business Mailing Address
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Address Line | 3311 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3688
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Country | US
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Telephone | 718-667-6776
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Fax | 718-980-1317
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 162899
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License Number State | NY
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