Provider Demographics
NPI:1750570784
Name:KAAFARANI, HAYTHAM M (MD, MPH)
Entity type:Individual
Prefix:
First Name:HAYTHAM
Middle Name:M
Last Name:KAAFARANI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MONMOUTH ST
Mailing Address - Street 2:APT 911
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5680
Mailing Address - Country:US
Mailing Address - Phone:813-675-5989
Mailing Address - Fax:
Practice Address - Street 1:101 MONMOUTH ST
Practice Address - Street 2:APT 911
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5680
Practice Address - Country:US
Practice Address - Phone:813-675-5989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2342772086S0102X, 2086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery