Basic Information
| Provider Information | |||||||||
| NPI: | 1629087507 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GAROFANO | ||||||||
| FirstName: | SUZETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 1ST AVE | ||||||||
| Address2: | SUITE 5E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122638865 | ||||||||
| FaxNumber: | 2122630462 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 1ST AVE | ||||||||
| Address2: | SUITE 5E | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122638865 | ||||||||
| FaxNumber: | 2122630462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 173166 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 173166 | 01 | HIP | OTHER | 134004151 | 01 | 1199 | OTHER | 4884610006 | 01 | CIGNA | OTHER | 9600276 | 01 | GHI | OTHER | 2318640 | 01 | UNITED HEALTHCARE | OTHER | 1C5644 | 01 | HEALTHNET | OTHER |