Provider Demographics
NPI:1154485449
Name:CARAFA, CIRO J (MD)
Entity Type:Individual
Prefix:DR
First Name:CIRO
Middle Name:J
Last Name:CARAFA
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 1:4 HUNTER ST STE 206
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1608
Mailing Address - Country:US
Mailing Address - Phone:973-473-3896
Mailing Address - Fax:973-473-4806
Practice Address - Street 1:120 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2204
Practice Address - Country:US
Practice Address - Phone:973-473-7870
Practice Address - Fax:973-472-1455
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA40377207RR0500X
NJ25MA04037700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1254201Medicaid
NJ450894Medicare ID - Type Unspecified
NJC55138Medicare UPIN