Provider Demographics
NPI:1215068952
Name:CIUFFO, JOHN MICHAEL (RPH, JD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:CIUFFO
Suffix:
Gender:M
Credentials:RPH, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BRIGHTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-8108
Mailing Address - Country:US
Mailing Address - Phone:203-388-8613
Mailing Address - Fax:
Practice Address - Street 1:134 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4839
Practice Address - Country:US
Practice Address - Phone:203-324-0251
Practice Address - Fax:203-348-0093
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047052183500000X
CT6688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist