Provider Demographics
NPI:1801815105
Name:JAFFIN, BARRY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:WAYNE
Last Name:JAFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BARRY
Other - Middle Name:WAYNE
Other - Last Name:JAFFIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:620 COLUMBUS AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1458
Mailing Address - Country:US
Mailing Address - Phone:212-721-2600
Mailing Address - Fax:212-721-6230
Practice Address - Street 1:620 COLUMBUS AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1458
Practice Address - Country:US
Practice Address - Phone:212-721-2600
Practice Address - Fax:212-721-6230
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165157207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA60710Medicare UPIN
NY14E161Medicare PIN