Provider Demographics
NPI:1417650441
Name:CIUFFREDO, GEENA MARIA
Entity Type:Individual
Prefix:
First Name:GEENA
Middle Name:MARIA
Last Name:CIUFFREDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-1134
Mailing Address - Country:US
Mailing Address - Phone:978-368-8540
Mailing Address - Fax:978-368-7936
Practice Address - Street 1:1031 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-1134
Practice Address - Country:US
Practice Address - Phone:978-368-8540
Practice Address - Fax:978-368-7936
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPT24655156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist