Individual provider Active NPI

Vincent J Gulfo, MD

  • Physical Medicine & Rehabilitation Physician
  • Middletown, NY
National Provider Identifier
1679552111
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
162737 Issued in NY
Practice address
110 Crystal Run Rd
Middletown, NY 10941-4040
Phone
(845) 673-1071
Fax
(845) 695-1223
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 162737 NY Primary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 162737 NY
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 162737 NY
Spinal Cord Injury Medicine Physician 2081P0004X 162737 NY
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 162737 NY
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 162737 NY

Addresses

Primary practice location

110 Crystal Run Rd
Middletown, NY 10941-4040

Mailing address

PO Box 1068
Warwick, NY 10990-8067
Phone (845) 987-7260

Other identifiers 1

IdentifierTypeStateIssuer
01292837MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070116000455 NY Practitioner - Physical Medicine and Rehabilitation 3971504002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
162737NYMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1679552111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1068",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109908067",
            "telephone_number": "845-987-7260",
            "fax_number": "845-988-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414040",
            "telephone_number": "845-673-1071",
            "fax_number": "845-695-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULFO",
        "first_name": "VINCENT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "162737",
            "primary": true
        },
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "NY",
            "license": "162737",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NY",
            "license": "162737",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "NY",
            "license": "162737",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "162737",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "162737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01292837",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.