Provider Demographics
NPI:1689042269
Name:GAIL LOIS JAFFE, PA
Entity Type:Organization
Organization Name:GAIL LOIS JAFFE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:SATULOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-569-6826
Mailing Address - Street 1:333 17TH ST
Mailing Address - Street 2:SUITE 2T
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5670
Mailing Address - Country:US
Mailing Address - Phone:772-564-0406
Mailing Address - Fax:
Practice Address - Street 1:333 17TH ST
Practice Address - Street 2:SUITE 2T
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5670
Practice Address - Country:US
Practice Address - Phone:772-564-0406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-12
Last Update Date:2015-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH000312101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty