Provider Demographics
NPI:1376581298
Name:AFARI, JACQUELYN B (MD)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:B
Last Name:AFARI
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2409 BARKER AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-231-7800
Mailing Address - Fax:718-231-7850
Practice Address - Street 1:2409 BARKER AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-231-7800
Practice Address - Fax:718-231-7850
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2012-10-19
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Provider Licenses
StateLicense IDTaxonomies
NY206326207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H25338Medicare UPIN