Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MA61576 | NJ |
NPI | 1003877663 |
---|---|
Provider Name | Dr. Fatema Jaffery |
First Address | Edison, NJ 08820-2515 |
Second Address | Irvington, NJ 07111-3262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 28/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9022805 | (05) | NJ |