Provider Demographics
NPI:1508445560
Name:JAFFE, EDWARD MOLLESON (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:MOLLESON
Last Name:JAFFE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 COLUMBIA RD NW APT 215
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3646
Mailing Address - Country:US
Mailing Address - Phone:509-554-2283
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS STREET
Practice Address - Street 2:CWNL1
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-2610
Practice Address - Country:US
Practice Address - Phone:617-732-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1022828207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology