Provider Demographics
NPI:1568435261
Name:MARFATIA, RIPPLE MUKUND (MD)
Entity Type:Individual
Prefix:DR
First Name:RIPPLE
Middle Name:MUKUND
Last Name:MARFATIA
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 1:214 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-9523
Mailing Address - Country:US
Mailing Address - Phone:585-786-2769
Mailing Address - Fax:585-786-0508
Practice Address - Street 1:5596 ROUTE 19A
Practice Address - Street 2:
Practice Address - City:CASTILE
Practice Address - State:NY
Practice Address - Zip Code:14427-9757
Practice Address - Country:US
Practice Address - Phone:585-493-9230
Practice Address - Fax:585-786-0508
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-12
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY42-1636490OtherHUMANA
NY421636490OtherEMPIRE
NYP010100730OtherBLUE CHOICE
NY2710199OtherAETNA
NY42-1636490OtherTRICARE
NY421636490OtherUNITED HEALTH CARE
NY00010372202OtherUNIVERA
NY224172-7BOtherWORKERS COMPENSATION
NY000525403002OtherBCBS WNY
NYP020100730OtherBLUE SHIELD
NY106101BJOtherPREFERRED CARE
NY2514266OtherGHI
NY000525403003OtherBCBS WNY
NY01916687Medicaid
NY7774326OtherAETNA
NY0410493OtherINDEPEDENT HEALTH