Provider Demographics
NPI:1336335173
Name:FRANK R SCIFO MD
Entity Type:Organization
Organization Name:FRANK R SCIFO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-386-0099
Mailing Address - Street 1:2595 MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-5855
Mailing Address - Country:US
Mailing Address - Phone:203-386-0366
Mailing Address - Fax:203-380-1495
Practice Address - Street 1:2595 MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5855
Practice Address - Country:US
Practice Address - Phone:203-386-0366
Practice Address - Fax:203-380-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03136Medicare PIN