Provider Demographics
NPI:1235295387
Name:JAFFE, RALPH H (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:H
Last Name:JAFFE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8229 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2429
Mailing Address - Country:US
Mailing Address - Phone:215-782-8861
Mailing Address - Fax:215-689-2880
Practice Address - Street 1:8229 FORREST AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2429
Practice Address - Country:US
Practice Address - Phone:215-782-8861
Practice Address - Fax:215-689-2880
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 006876 L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical