Organization · NPI-2

Anthony J Garofalo

Podiatrist · Staten Island, NY

NPI number1184879504
StatusActive
Last updated in NPPESDec 8, 2011

Details

NPI
1184879504
Entity type
Organization (NPI-2)
Legal business name
Anthony J Garofalo
Organization subpart
No
Enumeration date
Nov 26, 2008
Last updated
Dec 8, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X PodiatristN004340NYYes

Practice location

1946 Victory Blvd
Staten Island, NY 10314

Phone 718-442-4272 · Fax 718-442-4292

Mailing address

Po Box 995
Whitehouse Station, NJ 08889-0995

Phone 718-442-4272 · Fax 718-442-4292

Authorized official

Anthony Joseph Garofalo
Sole Proprietor
7184424272

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