Provider Demographics
NPI:1639396542
Name:DR. ALI M. JAFARI DC PC
Entity Type:Organization
Organization Name:DR. ALI M. JAFARI DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAFARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-688-8108
Mailing Address - Street 1:711 BORDEN RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-3232
Mailing Address - Country:US
Mailing Address - Phone:716-668-8108
Mailing Address - Fax:716-668-8253
Practice Address - Street 1:711 BORDEN RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-3232
Practice Address - Country:US
Practice Address - Phone:716-668-8108
Practice Address - Fax:716-668-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX2918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA1185Medicare PIN
NYW99855Medicare UPIN