Provider Demographics
NPI:1376869693
Name:JAFFE, SCOTT (DC, RPH)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:JAFFE
Suffix:
Gender:M
Credentials:DC, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 N OLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638
Mailing Address - Country:US
Mailing Address - Phone:609-219-0076
Mailing Address - Fax:609-219-0655
Practice Address - Street 1:1750 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3100
Practice Address - Country:US
Practice Address - Phone:609-219-0076
Practice Address - Fax:609-219-0655
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02637800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist