Provider Demographics
NPI:1932204922
Name:CARFORA, ROXANNE GAIL (DO)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:GAIL
Last Name:CARFORA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:412 N COUNTRY RD
Mailing Address - Street 2:STE 10
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-1761
Mailing Address - Country:US
Mailing Address - Phone:631-250-9582
Mailing Address - Fax:631-250-9615
Practice Address - Street 1:412 N COUNTRY RD
Practice Address - Street 2:STE 10
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-1761
Practice Address - Country:US
Practice Address - Phone:631-250-9582
Practice Address - Fax:631-250-9615
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY186098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF59109Medicare UPIN
NY69H951Medicare ID - Type UnspecifiedMEDICARE ID NUMBER