Provider Demographics
NPI:1730139304
Name:JAFFERY, NASIMA NEELOFER (MD)
Entity Type:Individual
Prefix:
First Name:NASIMA
Middle Name:NEELOFER
Last Name:JAFFERY
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 1:102 WILLIAMSPORT CIR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6400
Mailing Address - Country:US
Mailing Address - Phone:443-978-7028
Mailing Address - Fax:443-944-9023
Practice Address - Street 1:102 WILLIAMSPORT CIR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6400
Practice Address - Country:US
Practice Address - Phone:443-978-7028
Practice Address - Fax:443-944-9023
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00643522081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0064352OtherMARYLAND LICENSE
MDBJ8860923OtherDEA
MDBJ8860923OtherDEA
MDD0064352OtherMARYLAND LICENSE