Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 162613 | NY |
NPI | 1083790414 |
---|---|
Provider Name | Dr. Rocco J Lafaro |
First Address | Valhalla, NY 10595 |
Second Address | Valhalla, NY 10595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 29/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01144343 | (05) | NY |
E17268 | (02) | NY |