Provider Demographics
NPI:1477964591
Name:GIUFFRIDA, STEPHAN I (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:
Last Name:GIUFFRIDA
Suffix:I
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-1706
Mailing Address - Country:US
Mailing Address - Phone:914-779-5800
Mailing Address - Fax:914-779-5802
Practice Address - Street 1:335 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-1706
Practice Address - Country:US
Practice Address - Phone:914-779-5800
Practice Address - Fax:914-779-5800
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012501OtherLICENCE