Provider Demographics
NPI:1881855377
Name:JAFARY, AHMAR (DO)
Entity Type:Individual
Prefix:DR
First Name:AHMAR
Middle Name:
Last Name:JAFARY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0055 MORLOT AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1016
Mailing Address - Country:US
Mailing Address - Phone:201-655-4367
Mailing Address - Fax:
Practice Address - Street 1:0055 MORLOT AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1016
Practice Address - Country:US
Practice Address - Phone:201-655-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00001207RI0200X
PAOS016864207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103226505Medicaid
PA552353FLTMedicare PIN