Provider Demographics
NPI:1649259045
Name:GAFFIN, NEIL (MD)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:GAFFIN
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 1:947 LINWOOD AVE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2939
Mailing Address - Country:US
Mailing Address - Phone:201-447-6468
Mailing Address - Fax:201-447-3189
Practice Address - Street 1:947 LINWOOD AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2939
Practice Address - Country:US
Practice Address - Phone:201-447-6468
Practice Address - Fax:201-447-3189
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA71002207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ440003137OtherRAILROAD MEDICARE#
NJ91001232500OtherAMERICHOICE#
NY2509827OtherGHI PPO#
NJ5931557OtherAETNA PPO#
NJ1144615OtherHORIZON NJ HEALTH#
NJ2454996OtherAETNA HMO#
NJ2K1089OtherHEALTHNET#
NJP401053OtherOXFORD#
NJ100067OtherAMERIGROUP#
NY862162OtherEMPIRE BC/BS#
NY2509827OtherGHI PPO#
NJ5931557OtherAETNA PPO#