Provider Demographics
NPI:1093718397
Name:SCLAFANI, JOSEPH F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:SCLAFANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5453
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5453
Mailing Address - Country:US
Mailing Address - Phone:718-780-3272
Mailing Address - Fax:718-780-3079
Practice Address - Street 1:506 6 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3272
Practice Address - Fax:718-780-3079
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35042288207V00000X
NY243259207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0701210OtherUNITED HEALTHCARE
OH296446052006OtherMEDICAL MUTUAL
OH31157505104OtherCARESOURCE
OH288143OtherAMERIGROUP
OH000000020963OtherANTHEM
OH993552OtherAETNA
OH0465778Medicaid
OHSC0496824Medicare ID - Type Unspecified
OH296446052006OtherMEDICAL MUTUAL
OHSC0496826Medicare ID - Type Unspecified
OH0465778Medicaid
OH31157505104OtherCARESOURCE