Provider Demographics
NPI:1992327803
Name:GAROFALO, CHRISTOPHER J
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:GAROFALO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 MEMORIAL DR APT 406
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-5177
Mailing Address - Country:US
Mailing Address - Phone:718-619-7940
Mailing Address - Fax:
Practice Address - Street 1:137 NEWTONS CORNER RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2890
Practice Address - Country:US
Practice Address - Phone:732-206-0408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028346001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice