Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 028526 | CT |
Y | 207X00000X | Orthopaedic Surgeon | 112796 | NY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 028526 | CT |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 112796 | NY |
NPI | 1659469641 |
---|---|
Provider Name | Robert Louis Cristofaro |
First Address | Purchase, NY 10577-2524 |
Second Address | Purchase, NY 10577-2535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 01/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00347411 | (05) | NY |
A63905 | (02) |