Provider Demographics
NPI:1467756890
Name:GAFFUD, MARIA CECILIA GARCIA (DPM)
Entity Type:Individual
Prefix:MRS
First Name:MARIA CECILIA
Middle Name:GARCIA
Last Name:GAFFUD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MS
Other - First Name:MARIA CELILIA
Other - Middle Name:ORTEGA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:581 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-0000
Mailing Address - Country:US
Mailing Address - Phone:516-569-2828
Mailing Address - Fax:516-295-4145
Practice Address - Street 1:581 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-0000
Practice Address - Country:US
Practice Address - Phone:516-569-2828
Practice Address - Fax:516-295-4145
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005236213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist