Basic Information
Provider Information
NPI: 1003013533
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CIOFFI
FirstName: GEORGE
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 635 W 165TH ST
Address2: HARKNESS EYE INSTITUTE
City: NEW YORK
State: NY
PostalCode: 100323724
CountryCode: US
TelephoneNumber: 2123056709
FaxNumber: 2123055523
Practice Location
Address1: 635 W 165TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100323724
CountryCode: US
TelephoneNumber: 2123059535
FaxNumber: 2123056709
Other Information
ProviderEnumerationDate: 06/28/2007
LastUpdateDate: 02/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X264920NYY Allopathic & Osteopathic PhysiciansOphthalmology 
207WX0009X264920NYN    

ID Information
IDTypeStateIssuerDescription
0347510105NY MEDICAID
03967205OR MEDICAID


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