Provider Demographics
NPI:1477638302
Name:JAFAR, SALEHA (MD)
Entity Type:Individual
Prefix:
First Name:SALEHA
Middle Name:
Last Name:JAFAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1212
Mailing Address - Country:US
Mailing Address - Phone:845-566-5641
Mailing Address - Fax:845-566-5674
Practice Address - Street 1:312 N PLANK RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-8858
Practice Address - Country:US
Practice Address - Phone:845-566-5641
Practice Address - Fax:845-566-5674
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS43182083A0300X
NY216726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02251018Medicaid
NY02251018Medicaid
NY858821Medicare ID - Type Unspecified