1518913441 NPI number — SYED ALI JAFFRY LLC

Table of content: (NPI 1518913441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518913441 NPI number — SYED ALI JAFFRY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SYED ALI JAFFRY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518913441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7140
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLONIA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07067-7140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-535-6668
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
240 WILLIAMSON ST
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07202-3674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-353-6668
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JAFFRY
Authorized Official First Name:
SYED
Authorized Official Middle Name:
ALI
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
908-353-6668

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  MA66784 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8166706 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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