Provider Demographics
NPI:1740228188
Name:PFAFF, H CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:H
Middle Name:CHARLES
Last Name:PFAFF
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 1:1 GUSTAVE L. LEVY PLACE
Mailing Address - Street 2:BOX 1194
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-8395
Mailing Address - Fax:212-289-0092
Practice Address - Street 1:1 GUSTAVE L. LEVY PLACE
Practice Address - Street 2:BOX 1194
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-8395
Practice Address - Fax:212-289-0092
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1747312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY68F531Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID#
E62553Medicare UPIN
NY01357946Medicaid