Provider Demographics
NPI:1225361165
Name:JAFFE, ASHLEE M (MD, MED)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:M
Last Name:JAFFE
Suffix:
Gender:F
Credentials:MD, MED
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:M
Other - Last Name:GOLDSMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:238 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-7331
Mailing Address - Country:US
Mailing Address - Phone:224-234-6834
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:DIVISION OF REHABILITATION MEDICINE, CSH 2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-7439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4475492081P0010X
PAMT195993208100000X
OH57.0205922081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT195993OtherPENNSYLVANIA LICENSE