Provider Demographics
NPI:1811166556
Name:JEFFREY MUROFF DPM PC
Entity type:Organization
Organization Name:JEFFREY MUROFF DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUROFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-588-0888
Mailing Address - Street 1:500 PORTION RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-4587
Mailing Address - Country:US
Mailing Address - Phone:631-588-0888
Mailing Address - Fax:631-588-1193
Practice Address - Street 1:500 PORTION RD
Practice Address - Street 2:SUITE 1
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-4587
Practice Address - Country:US
Practice Address - Phone:631-588-0888
Practice Address - Fax:631-588-1193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005902332B00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02526938Medicaid
NY02526938Medicaid
NYPH5661Medicare PIN
NYU95220Medicare UPIN