Provider Demographics
NPI:1467677385
Name:MARFORI, MICHELLE P (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:P
Last Name:MARFORI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:MARFORI
Other - Last Name:D'ALTERIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20 BRICK PLZ
Mailing Address - Street 2:56 CHAMBERS BRIDGE RD.
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4045
Mailing Address - Country:US
Mailing Address - Phone:732-920-1775
Mailing Address - Fax:732-920-1381
Practice Address - Street 1:20 BRICK PLZ
Practice Address - Street 2:56 CHAMBERS BRIDGE RD.
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4045
Practice Address - Country:US
Practice Address - Phone:732-920-1775
Practice Address - Fax:732-920-1381
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00550200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA005728Medicare ID - Type Unspecified
NJU69007Medicare UPIN