1487615050 NPI number — DR. SYED JAFFRY MD

Table of content: DR. SYED JAFFRY MD (NPI 1487615050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487615050 NPI number — DR. SYED JAFFRY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAFFRY
Provider First Name:
SYED
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1487615050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/24/2008
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:
908-353-6668
Provider Business Mailing Address Fax Number:
732-603-0624

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:
908-353-6608
Provider Business Practice Location Address Fax Number:
732-603-0624
Provider Enumeration Date:
03/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X , with the licence number:  MA67784 , 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".




Copyright © 2007-2025 www.npivalidator.com