Provider Demographics
NPI:1952572307
Name:TAFURI, KIMBERLY SUE (DO)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:SUE
Last Name:TAFURI
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:100 NICOLLS RD
Mailing Address - Street 2:STONY BROOK HOSPITAL DEPT OF PEDIATRICS HSC T11 ROOM080
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8111
Mailing Address - Country:US
Mailing Address - Phone:631-444-3429
Mailing Address - Fax:631-444-6045
Practice Address - Street 1:100 NICOLLS RD
Practice Address - Street 2:STONY BROOK HOSPITAL DEPT OF PEDIATRICS HSC T11 ROOM080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8111
Practice Address - Country:US
Practice Address - Phone:631-444-3429
Practice Address - Fax:631-444-6045
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2520222080P0205X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program