Individual
JOHN R STAFFORD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 E MAIN ST, NORTHERN WESTCHESTER HOSPITAL 3RD FLOOR, MOUNT KISCO, NY 10549-3417
(914) 666-1272
(914) 666-1002
Mailing address
400 E MAIN ST, NORTHERN WESTCHESTER HOSPITAL 3RD FLOOR, MOUNT KISCO, NY 10549-3417
(914) 666-1272
(914) 666-1002
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
173853
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000032942
GHI-HMO
—
05
—
01141928
—
NY
01
—
0958352
AETNA-HMO
—
01
—
10098634-T818
CDPHP PIN & GRP #
—
01
—
1IJ241
EMPIRE BC-BS
—
01
—
2695234
GHI-PPO
—
01
—
376982
MVP PROVIDER ID #
—
01
—
4340420
AETNA-PPO
—
01
—
5C4323
HEALTHNET PIN #
—
01
—
WS408
OXFORD PIN#
—
Enumeration date
09/06/2005
Last updated
07/08/2007
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