Individual
MR. STAFFORD D JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3435 70TH ST, JACKSON HEIGHTS, NY 11372-1055
(718) 651-9700
(718) 533-0264
Mailing address
723 REMSEN AVE, BROOKLYN, NY 11236-1227
(718) 345-9106
(718) 533-0264
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
—
174400000X
Specialist
020469
NY
207RN0300X
Nephrology Physician
Primary
020469
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01918556
—
NY
Enumeration date
12/15/2005
Last updated
12/05/2014
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