Provider Demographics
NPI:1629087507
Name:GAROFANO, SUZETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:
Last Name:GAROFANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:SUITE 5E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-8865
Mailing Address - Fax:212-263-0462
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 5E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-8865
Practice Address - Fax:212-263-0462
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173166207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
173166OtherHIP
134004151Other1199
4884610006OtherCIGNA
9600276OtherGHI
2318640OtherUNITED HEALTHCARE
1C5644OtherHEALTHNET
F24546Medicare UPIN
173166OtherHIP