Provider Demographics
NPI:1447782719
Name:JAFRI, MUSTAFA HUSSAIN
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:HUSSAIN
Last Name:JAFRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LINCOLN HWY STE 302
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3904
Mailing Address - Country:US
Mailing Address - Phone:732-548-1610
Mailing Address - Fax:
Practice Address - Street 1:2 LINCOLN HWY STE 302
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3904
Practice Address - Country:US
Practice Address - Phone:732-548-1610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11809300207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease