Provider Demographics
NPI:1053539585
Name:ACQUAFREDDA, SAVERIO (MD)
Entity type:Individual
Prefix:DR
First Name:SAVERIO
Middle Name:
Last Name:ACQUAFREDDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1308
Mailing Address - Country:US
Mailing Address - Phone:718-987-4848
Mailing Address - Fax:
Practice Address - Street 1:212 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1308
Practice Address - Country:US
Practice Address - Phone:718-987-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086524207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB10868Medicare UPIN
NY198331Medicare ID - Type Unspecified