Provider Demographics
NPI:1821095365
Name:GAROFALO, FRANCIS ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:GAROFALO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 GREEN ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1396
Mailing Address - Country:US
Mailing Address - Phone:978-669-5522
Mailing Address - Fax:978-669-5521
Practice Address - Street 1:250 GREEN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-1396
Practice Address - Country:US
Practice Address - Phone:978-669-5522
Practice Address - Fax:978-669-5521
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238888208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT349140OtherDMBA PROVIDER
UT107042289101OtherIHC PROVIDER
UT85609OtherPEHP PROVIDER
UT870562879GAROtherEMIA PROVIDER
UT005575304OtherHUMANA PROVIDER
UT266885OtherALTIUS PROVIDER
UTPOO262946OtherRR MCARE PROVIDER
UT60119791200001OtherBCBS PROVIDER
UT005575304Medicare ID - Type UnspecifiedMEDICARE PROVIDER
UT107042289101OtherIHC PROVIDER
UT266885OtherALTIUS PROVIDER
UT60119791200001OtherBCBS PROVIDER
UTPOO262946OtherRR MCARE PROVIDER