Provider Demographics
NPI:1083632228
Name:JAFFE, DAVID H (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:JAFFE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 GIBBON ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3836
Mailing Address - Country:US
Mailing Address - Phone:203-368-8036
Mailing Address - Fax:
Practice Address - Street 1:1 IRVING PL
Practice Address - Street 2:
Practice Address - City:CHAUTAUQUA
Practice Address - State:NY
Practice Address - Zip Code:14722-2522
Practice Address - Country:US
Practice Address - Phone:203-368-8036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313899207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060855634003OtherCIGNA CT
CO500HBA011CT01OtherBCBS CT
CTA770995OtherOXFORD HEALTH PLANS
CT95012OtherHEALTH NET
CTP00126836OtherRAILROAD MEDICARE
CT755806OtherCONNECTICARE
CT4495952OtherAETNA CT
CTCHN858OtherCOMMUNITY HEALTH NETWORK
CTCHN858OtherCOMMUNITY HEALTH NETWORK
CT50000354Medicare ID - Type Unspecified