Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 162737 | NY |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 162737 | NY |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 162737 | NY |
N | 2081P2900X | Pain Medicine | 162737 | NY |
N | 2081S0010X | Sports Medicine | 162737 | NY |
N | 213ES0000X | Sports Medicine | 162737 | NY |
NPI | 1679552111 |
---|---|
Provider Name | Vincent J Gulfo |
First Address | Warwick, NY 10990-8067 |
Second Address | Middletown, NY 10941-4040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 31/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01292837 | (05) | NY |
E10662 | (02) |