NPIMap

Organization Active NPI

Roxanne G Carfora, DO, PC

Doing business as Ageless 360 Medical Group

  • Family Medicine Physician
  • Hauppauge, NY
National Provider Identifier
1962830851
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
186098 Issued in NY
Legal business name
ROXANNE G CARFORA, DO, PC
Doing business as
Ageless 360 Medical Group
Practice address
694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175
Phone
(631) 265-9355
Fax
(631) 864-8504
NPI assigned
Oct 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Dr. Roxanne G Carfora, DO
Title
Physician/Medical Director
Phone
(631) 265-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 186098 NY Primary

Addresses

Primary practice location

694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175

Mailing address

694 Motor Pkwy
Suite 101
Hauppauge, NY 11788-5175
Phone (631) 265-9355

Other names 1

  • Ageless 360 Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

266 Middle Country Rd
Coram, NY 11727
Phone (631) 475-3900

5499 Route 347
Mount Sinai, NY 11766
Phone (631) 331-3910

6144 Route 25A
#G10
Wading River, NY 11792
Phone (631) 929-5900

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1962830851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 MOTOR PKWY",
            "address_2": "SUITE 101",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885175",
            "telephone_number": "631-265-9355",
            "fax_number": "631-864-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 MOTOR PKWY",
            "address_2": "SUITE 101",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117885175",
            "telephone_number": "631-265-9355",
            "fax_number": "631-864-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROXANNE G CARFORA, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-31",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "CARFORA",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PHYSICIAN/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "631-265-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "186098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless 360 Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.