Provider Demographics
NPI:1548399744
Name:ADIL N JAFFER MD INC
Entity Type:Organization
Organization Name:ADIL N JAFFER MD INC
Other - Org Name:JAFFER MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ADIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-759-7038
Mailing Address - Street 1:4308 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1052
Mailing Address - Country:US
Mailing Address - Phone:330-759-7038
Mailing Address - Fax:
Practice Address - Street 1:4308 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1052
Practice Address - Country:US
Practice Address - Phone:330-759-7038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.084317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHY29866Medicare UPIN
OHAD9351641Medicare ID - Type Unspecified