Provider Demographics
NPI:1841818184
Name:ROUFAIEL, JOHN MAGDY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MAGDY
Last Name:ROUFAIEL
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 1:6230 REESE RD APT 103
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-1268
Mailing Address - Country:US
Mailing Address - Phone:315-280-8484
Mailing Address - Fax:
Practice Address - Street 1:750 E ADAMS ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1834
Practice Address - Country:US
Practice Address - Phone:315-492-3400
Practice Address - Fax:315-464-7106
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program