Provider Demographics
NPI:1568430031
Name:JAFFER, SUKAINA J (MD)
Entity Type:Individual
Prefix:
First Name:SUKAINA
Middle Name:J
Last Name:JAFFER
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 1:100 MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9762
Mailing Address - Country:US
Mailing Address - Phone:412-359-3060
Mailing Address - Fax:412-359-3060
Practice Address - Street 1:100 MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-9762
Practice Address - Country:US
Practice Address - Phone:412-359-3060
Practice Address - Fax:412-359-3060
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067495A207R00000X
VA0101222944207R00000X
NY206620207R00000X
OH35.082142207R00000X
PAMD060658L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2631656Medicaid
OHH049862Medicare PIN
OHPENDINGMedicaid