Provider Demographics
NPI:1679837447
Name:GARUFI, JENNIFER REBECCA (MSED)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:REBECCA
Last Name:GARUFI
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-3229
Mailing Address - Country:US
Mailing Address - Phone:914-434-1151
Mailing Address - Fax:
Practice Address - Street 1:70 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8704
Practice Address - Country:US
Practice Address - Phone:914-434-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15775174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist