Provider Demographics
NPI:1710945472
Name:JAFAR, RASHEED U (MD)
Entity Type:Individual
Prefix:
First Name:RASHEED
Middle Name:U
Last Name:JAFAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 GRAND AVE
Mailing Address - Street 2:ATT: PHYSICIAN BILLING
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1943
Mailing Address - Country:US
Mailing Address - Phone:516-223-3804
Mailing Address - Fax:516-379-7627
Practice Address - Street 1:1510 GRAND AVE
Practice Address - Street 2:ATT: PHYSICIAN BILLING
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1943
Practice Address - Country:US
Practice Address - Phone:516-223-3804
Practice Address - Fax:516-379-7627
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122644174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0394023Medicaid
NYB17905Medicare UPIN
NYB17905Medicare UPIN