Provider Demographics
NPI:1790744902
Name:JAFFE FRIEDMAN MD PA
Entity Type:Organization
Organization Name:JAFFE FRIEDMAN MD PA
Other - Org Name:COMPREHENSIVE WOMENS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-871-4346
Mailing Address - Street 1:PO BOX 34230
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07189-0230
Mailing Address - Country:US
Mailing Address - Phone:201-871-4346
Mailing Address - Fax:201-871-5953
Practice Address - Street 1:401 S VAN BEUNT ST
Practice Address - Street 2:SUITE 405
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-871-4346
Practice Address - Fax:201-871-5953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
020551Medicare ID - Type Unspecified