Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 208841 | NY |
NPI | 1043235088 |
---|---|
Provider Name | Dr. Alfred Culliford |
First Address | Staten Island, NY 10305-4900 |
Second Address | Staten Island, NY 10305-3408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 16/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02149122 | (05) | NY |
I51770 | (02) | NY |
P00383405 | RR MEDICARE (01) | NY |