Provider Demographics
NPI:1669883526
Name:JAFFA, MATTHEW N (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:N
Last Name:JAFFA
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 1:80 SEYMOUR STREET
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-972-3621
Mailing Address - Fax:
Practice Address - Street 1:80 SEYMOUR STREET
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-972-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT651162084N0400X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology