Provider Demographics
NPI:1457446692
Name:CAFARO, MICHAEL PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PHILIP
Last Name:CAFARO
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 1:4719 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1733
Mailing Address - Country:US
Mailing Address - Phone:203-268-3816
Mailing Address - Fax:203-261-0566
Practice Address - Street 1:4719 MADISON AVE
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1733
Practice Address - Country:US
Practice Address - Phone:203-268-3816
Practice Address - Fax:203-261-0566
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT036037207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001360370OtherSTATE WELFARE
CTF95511Medicare UPIN
CT110006757Medicare PIN