Provider Demographics
NPI:1174588446
Name:GAROFALO, ALFRED A (DPM)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:A
Last Name:GAROFALO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:132 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1334
Mailing Address - Country:US
Mailing Address - Phone:212-238-7593
Mailing Address - Fax:212-238-7046
Practice Address - Street 1:227 MADISON ST
Practice Address - Street 2:5TH FLOOR 567
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7537
Practice Address - Country:US
Practice Address - Phone:212-238-7593
Practice Address - Fax:212-238-7046
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005045213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU41363Medicare UPIN
NYP61251Medicare ID - Type UnspecifiedMEDICARE