Provider Demographics
NPI:1043238884
Name:GAROFALO, CHRISTOPHER (MD,)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:GAROFALO
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:562 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6942
Mailing Address - Country:US
Mailing Address - Phone:508-761-5650
Mailing Address - Fax:508-761-9870
Practice Address - Street 1:562 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SOUTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-6942
Practice Address - Country:US
Practice Address - Phone:508-761-5650
Practice Address - Fax:508-761-9870
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000033327OtherBOSTON HEALTHNET
MA0038373OtherNEIGHBORHOOD HEALTH PLAN
RI408783OtherRHODE ISLAND BLUE CROSS
RI31569-2OtherRHODE ISLAND BLUE CROSS
MA711515OtherHARVARD PILGRIM HEALTH
TUFTSOther204265
H26961Medicare UPIN
MA000000033327OtherBOSTON HEALTHNET