Provider Demographics
NPI:1336195635
Name:SCANIFFE, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SCANIFFE
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 1:11 GLENMORE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1430
Mailing Address - Country:US
Mailing Address - Phone:860-677-9702
Mailing Address - Fax:
Practice Address - Street 1:309 SEASIDE AVE
Practice Address - Street 2:SUITE201
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4625
Practice Address - Country:US
Practice Address - Phone:203-783-1831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041917174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist