Provider Demographics
NPI:1861664708
Name:JAFFE, KENNETH ROBERT (DVM)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ROBERT
Last Name:JAFFE
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 1082
Mailing Address - Street 2:27 LENAPE AVE
Mailing Address - City:ANDOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-1082
Mailing Address - Country:US
Mailing Address - Phone:973-786-6991
Mailing Address - Fax:973-786-6991
Practice Address - Street 1:27 LENAPE AVE
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:NJ
Practice Address - Zip Code:07821-1082
Practice Address - Country:US
Practice Address - Phone:973-786-6991
Practice Address - Fax:973-786-6991
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00151500174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian