MEDICARE: DR. RICHARD EDWARD IOFFREDA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MA54000	NJ

General Provider Information

NPI Number	:	1780752964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD EDWARD IOFFREDA M.D.

Provider Business Mailing Address
First Line	:	1250 MARIGOLD STREET
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902
Country	:	US
Telephone Number	:	732-545-8259
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 MARIGOLD ST
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1722
Country	:	US
Telephone Number	:	732-545-8259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/19/2011

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