Provider Demographics
NPI:1831656438
Name:JAFARY, MAHSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAHSA
Middle Name:
Last Name:JAFARY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E 65TH ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6849
Mailing Address - Country:US
Mailing Address - Phone:917-539-4965
Mailing Address - Fax:
Practice Address - Street 1:315 E 65TH ST APT 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6849
Practice Address - Country:US
Practice Address - Phone:917-539-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048280-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY048280-1OtherSTATE LICENSE
048280-1OtherSTATE LICENSE