Basic Information
| Provider Information | |||||||||
| NPI: | 1073524310 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARUFI | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | CONTILLO | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | FAMILY PRACTICE | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CLARK | ||||||||
| OtherFirstName: | LINDA | ||||||||
| OtherMiddleName: | GARUFI | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1101 NORTHAMPTON ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180424152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108207605 | ||||||||
| FaxNumber: | 6108418457 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 NORTHAMPTON ST STE 102 | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180424152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108207605 | ||||||||
| FaxNumber: | 6108418457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2006 | ||||||||
| LastUpdateDate: | 05/11/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 216365 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD449737 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0080097 | 01 | MA | EVERCARE-GROUP | OTHER | 0006767 | 01 | MA | NHP-GROUP | OTHER | 0031546 | 01 | MA | NHP | OTHER | 1300709 | 05 | MA | MEDICAID | AA7111 | 01 | MA | HARVARD PILGRIM | OTHER | 97138601 | 01 | MA | NETWORK HEALTH | OTHER | J27420 | 01 | MA | BCBS | OTHER | 0105214 | 01 | MA | EVERCARE | OTHER | 042485308 | 01 | MA | NETWORK HEALTH- GROUP | OTHER | 237770 | 01 | MA | UNITED HEALTHCARE | OTHER | Y10141 | 01 | MA | BCBS-GROUP | OTHER | 67939 | 01 | MA | FALLON SELECT | OTHER | 8475467 | 01 | MA | CMSP | OTHER | 8475467 | 01 | MA | CIGNA | OTHER |