Provider Demographics
NPI:1740226158
Name:SCARFO, DAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:JOSEPH
Last Name:SCARFO
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 1:15 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1201
Mailing Address - Country:US
Mailing Address - Phone:203-984-6293
Mailing Address - Fax:
Practice Address - Street 1:1776 RICHMOND RD
Practice Address - Street 2:RICHMOND PRIMARY CARE STE 5
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2581
Practice Address - Country:US
Practice Address - Phone:718-668-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174958207R00000X
CT041010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG59500Medicare UPIN