Provider Demographics
NPI:1588748396
Name:CIUFFO, ROSEANN C (MD)
Entity type:Individual
Prefix:
First Name:ROSEANN
Middle Name:C
Last Name:CIUFFO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1523
Mailing Address - Country:US
Mailing Address - Phone:718-205-1413
Mailing Address - Fax:718-457-5931
Practice Address - Street 1:7301 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-1523
Practice Address - Country:US
Practice Address - Phone:718-205-1413
Practice Address - Fax:718-457-5931
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173705207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01571324Medicaid
NY1C3739OtherHEALTHNET PPROVIDER ID
NYNP1072OtherOXFORD HEALTH PLANS ID
NY26F272OtherEMPIREBLUECROSS/SHIELD ID
NY4600016OtherGHI PROVIDER ID
NY434432NOtherCIGNA PROVIDER ID
NYE17705Medicare UPIN
NY26F272OtherEMPIREBLUECROSS/SHIELD ID