=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700881349
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARY C GARFIELD DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2005
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 518 BROADWAY
-----------------------------------------------------
City | MONTICELLO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12701-1157
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-794-1600
-----------------------------------------------------
Fax | 845-794-0749
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 111 MALTESE DR
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10940-2115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-342-4774
-----------------------------------------------------
Fax | 845-343-8741
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 115523
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 115523
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------