Provider Demographics
NPI:1184788457
Name:DR CLIFFORD ROFFIS AND ASSOCIATES ODPC
Entity type:Organization
Organization Name:DR CLIFFORD ROFFIS AND ASSOCIATES ODPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROFFIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-226-1144
Mailing Address - Street 1:4811 S LABURNUM AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2713
Mailing Address - Country:US
Mailing Address - Phone:804-226-1144
Mailing Address - Fax:804-236-9026
Practice Address - Street 1:4811 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2713
Practice Address - Country:US
Practice Address - Phone:804-226-1144
Practice Address - Fax:804-236-9026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADA5536OtherRAILROAD MEDICARE PIN
VA106770OtherANTHEM
VA465284OtherAETNA US HEALTHCARE
VA34796OtherDAVIS
VAT21362OtherRAILROAD MEDICARE UPIN
VAVA1073OtherEYEMED VISION CARE
VA276556OtherSOUTHERN HEALTH
VA314973OtherALLIANCE PPO
VA9205403Medicaid
VAP00063025OtherRAILROAD MEDICARE
VA465284OtherAETNA US HEALTHCARE
VA34796OtherDAVIS
VA9205403Medicaid
VAP00063025OtherRAILROAD MEDICARE