Provider Demographics
NPI:1689042822
Name:JAFFAL, EMAD M (PHARM D)
Entity Type:Individual
Prefix:
First Name:EMAD
Middle Name:M
Last Name:JAFFAL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 83RD ST
Mailing Address - Street 2:APT 3F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4515
Mailing Address - Country:US
Mailing Address - Phone:347-599-8294
Mailing Address - Fax:
Practice Address - Street 1:756 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5511
Practice Address - Country:US
Practice Address - Phone:718-237-4526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist