Provider Demographics
NPI:1043692981
Name:CIAFFONE, MICHAEL ANDREW (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANDREW
Last Name:CIAFFONE
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 GIDNEY AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3741
Mailing Address - Country:US
Mailing Address - Phone:845-561-7075
Mailing Address - Fax:
Practice Address - Street 1:407 GIDNEY AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3741
Practice Address - Country:US
Practice Address - Phone:845-561-7075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF307368363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health